title: Strut-based accelerated partial breast irradiation: Report of treatment results for 250 consecutive patients at 5 years from a multicenter retrospective study.
abstract: This registry trial studied the long-term outcomes of women receiving accelerated partial breast irradiation (APBI) using strut-based applicators and reports on the local control, toxicity, and survival for the first 250 patients treated with this device.
  
  
  
  Patients were treated using the strut-based brachytherapy device with conventional dose and fractionation of 34 Gy in 10 twice-daily fractions. Planning goals for the planning target volume were V90> 90%, V150< 50 cc, and V200< 20 cc. Toxicity was graded based on the Common Terminology Criteria for Adverse Events v3.0. Recurrence rates were also calculated.
  
  
  
  Median followup was 59.5 months for the 250 patients. Grade 2 or higher adverse events at any time for hyperpigmentation, induration, erythema, telangiectasia, breast pain, seroma, and fat necrosis were 0.4%, 3.0%, 3.0%, 3.0%, 3.9%, 4.8%, and 1.3%, respectively. The median V90was 97%, V95was 95.1%, V150was 28.7 cc, and V200was 14.2 cc. For those patients with a less than a 5-mm or 3-mm-skin bridge, the median skin max doses were 272 and 289 cGy, respectively. The 4-year actuarial recurrence rates for true recurrence/marginal miss and ipsilateral breast tumor recurrence were 2.3% and 3.6%, respectively. The 4-year actuarial rates for overall survival, cause-specific survival, and disease-free survival were 97%, 98%, and 92%, respectively.
  
  
  
  The strut-based applicator was designed to simplify APBI compared to interstitial brachytherapy. This report confirms excellent tumor control and survival with low toxicity and supports the evidence that brachytherapy has less normal tissue toxicity than APBI with external beam irradiation.
authors.affiliation: Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA. Electronic address: cyashar@ucsd.edu.
authors.forename: Catheryn
authors.initials: C
authors.lastname: Yashar
authors.affiliation: UCLA Health Burbank Breast Care, Burbank, CA.
authors.forename: Deanna
authors.initials: D
authors.lastname: Attai
authors.affiliation: Schiffler Cancer Center, Wheeling Hospital, Wheeling, WV.
authors.forename: Ernest
authors.initials: E
authors.lastname: Butler
authors.affiliation: Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA.
authors.forename: John
authors.initials: J
authors.lastname: Einck
authors.affiliation: 21st Century Oncology Translational Research Center (TRC), Scottsdale, AZ.
authors.forename: Steven
authors.initials: S
authors.lastname: Finkelstein
authors.affiliation: South Florida Radiation Oncology, Boynton Beach, FL.
authors.forename: Ben
authors.initials: B
authors.lastname: Han
authors.affiliation: Virginia Hospital Center, Arlington, VA.
authors.forename: Robert
authors.initials: R
authors.lastname: Hong
authors.affiliation: Radiation Oncology, Drexel University College of Medicine, Philadelphia, PA.
authors.forename: Lydia
authors.initials: L
authors.lastname: Komarnicky
authors.affiliation: BioStat International, Inc., Tampa, FL.
authors.forename: Maureen
authors.initials: M
authors.lastname: Lyden
authors.affiliation: 21 Century Oncology, Fort Myers, FL.
authors.forename: Constantine
authors.initials: C
authors.lastname: Mantz
authors.affiliation: Texas Oncology, Denton, TX.
authors.forename: Serban
authors.initials: S
authors.lastname: Morcovescu
authors.affiliation: Radiation Oncology, Northwest Community Hospital, Arlington Heights, IL.
authors.forename: Stephen
authors.initials: S
authors.lastname: Nigh
authors.affiliation: Kerri Perry MD Denton, TX.
authors.forename: Kerri
authors.initials: K
authors.lastname: Perry
authors.affiliation: Schiffler Cancer Center, Wheeling Hospital, Wheeling, WV.
authors.forename: Jondavid
authors.initials: J
authors.lastname: Pollock
authors.affiliation: Radiation Oncology, Drexel University College of Medicine, Philadelphia, PA.
authors.forename: Jay
authors.initials: J
authors.lastname: Reiff
authors.affiliation: Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Scanderbeg
authors.affiliation: Arizona Breast Cancer Specialists, Scottsdale, AZ.
authors.forename: Margaret
authors.initials: M
authors.lastname: Snyder
authors.affiliation: Arizona Breast Cancer Specialists, Scottsdale, AZ.
authors.forename: Robert
authors.initials: R
authors.lastname: Kuske
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005218:Fat Necrosis / Q000209:etiology; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D011832:Radiation Injuries / Q000209:etiology; D011874:Radiometry / Q000379:methods; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012008:Recurrence; D012189:Retrospective Studies; D049291:Seroma / Q000209:etiology; D012867:Skin / Q000528:radiation effects; D013684:Telangiectasis / Q000209:etiology; D016896:Treatment Outcome
keywords: APBI; Balloon based; Brachytherapy; Breast brachytherapy; Breast conservation; Interstitial; Multilumen; SAVI; Strut; Strut based