Purpose or Objective
To report the long term results of elderly patients (75 years of age and older) treated in the II-phase prospective trial on accelerated partial breast irradiation efficacy using interstitial multicatheter high-dose-rate brachytherapy (HDR-BT) after breast-conserving surgery.
Material and Methods
A total of 425 patients with low-risk invasive and in situ carcinoma after BCS were treated using interstitial multicatheter HDR brachytherapy technique in our department between June 2006 and August 2019. The total dose was 32 Gy in 8 fractions delivered twice-daily with a minimum 6-hour break. There were 32 elderly patients enrolled in this study. The COIN and DHI indexes were calculated. Local recurrence and toxicity were evaluated.
The median age was 78 years ( range 75-85 years). The median follow-up was 44 months (range 1-120 months). The treatment was well tolerated. There were no complications associated with the procedure, and all of the patients completed the treatment without interruption.
The mean volume of the PTV was 61 cc., with the mean value of its coverage with the prescribed dose amounting to 94%
The mean conformity index (COIN) was 0,68, and the mean dose homogeneity index (DHI) was 0,64.
The mean value of the maximum skin dose was 49% of the prescribed dose.
The mean value of the ipsilateral lung dose to 2cc volume was 36,7% of the prescribed dose and to 10 cc volume was 27%. The mean maximum dose for the closest rib was 60 % of the prescribed dose.
There were no late severe complications. In our group of 32 patients, one local recurrence was noted. None of the patients suffered from distant metastasis. The five-year DFS was 93,75%
APBI with Interstitial Multicatheter High-Dose-Rate Brachytherapy is a safe and effective method. It can be taken into consideration in the management of elderly female breast cancer patients as an adjuvant treatment after previous surgery.
I have no potential conflict of interest to disclose
MD Piotr Lelek –I was born and raised Katowice, Poland. I work as a doctor in the Brachytherapy Departament in Maria Sklodowska-Curie Institute – Oncology Centre (MSCI), branch in Gliwice. I am mostly interested in salvage brachytherapy in prostate cancer patients and in postoperative breast irradiation.