Long-term results of intraoperative multicatheter breast implant (IOMBI) for accelerated partial breast irradiation (APBI) on early breast cancer patients

Multicatheter breast brachytherapy is a standard technique for accelerated partial breast irradiation (APBI) in early breast cancer patients. Intraoperative multicatheter breast implant (IOMBI) followed by perioperative high-dose-rate brachytherapy (PHDRBT) offers a novel and advantageous approach....

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Published in:Radiotherapy and oncology 2024-05, Vol.194, p.110193, Article 110193
Main Authors: Gimeno-Morales, Marta, Martínez-Monge, Rafael, Martinez-Lage, Adriana, Jablonska, Paola Anna, Blanco, Javier, Martínez-Regueira, Fernando, Rodriguez-Spiteri, Natalia, Olartecoechea, Begoña, Ramos, Luis, Insausti, Luis Pina, Elizalde, Arlette, Abengozar, Marta, Cambeiro, Mauricio
Format: Article
Language:English
Subjects:
Adult
Aged
Brachytherapy - adverse effects
Brachytherapy - instrumentation
Brachytherapy - methods
Breast Implants
Breast Neoplasms - pathology
Breast Neoplasms - radiotherapy
Breast Neoplasms - surgery
Female
Humans
Mastectomy, Segmental
Middle Aged
Radiotherapy Dosage
Treatment Outcome
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Summary:Multicatheter breast brachytherapy is a standard technique for accelerated partial breast irradiation (APBI) in early breast cancer patients. Intraoperative multicatheter breast implant (IOMBI) followed by perioperative high-dose-rate brachytherapy (PHDRBT) offers a novel and advantageous approach. We present long-term oncological, toxicity, and cosmesis outcomes for a well-experienced single institution. Eligible women aged ≥ 40 years with clinically and radiologically confirmed unifocal invasive or in situ ≤ 3 cm breast tumors underwent IOMBI during breast-conserving surgery. Patients meeting APBI criteria by definitive pathologic results received 3.4 Gy × 10fx with PHDRBT. Patients not suitable for APBI received PHDRBT-boost followed by WBRT. A total of 171 patients underwent IOMBI during BCS, 120 patients (70.1 %) were suitable for APBI and 51 (29.8 %) for anticipated PHDRBT-boost. The median age was 61 years (range: 40–78), the median tumor size was 1.1 cm (range: 0.2–3.5), with a histological diagnosis of invasive ductal carcinoma in 78.9 % and ductal in situ in 21.1 %. A median of 9 catheters (range: 4–14) were used. For APBI, the median CTV and V100 were 40.8 cc (range: 8.6–99) and 35.4 cc (range: 7.2–94). The median of healthy breast tissue irradiated represents 7.2 % (range: 2.3–28 %) and the median local treatment duration was 10 days (range: 7–16). With a median follow-up of 8.8 years (range: 0.3–16.25), the 8-year local, locoregional, and distant control rates were 99 %, 98.1 %, and 100 %. G1-G2 late-toxicity rate was 53.4 %. Long-term cosmetic evaluation was excellent-good in 90.8 %. IOMBI&PHDRBT program reports excellent long-term oncological outcomes, with a reduction from unnecessary irradiation exposure which translates into low long-term toxicity and good cosmesis outcomes, especially on well-selected APBI patients.
ISSN:0167-8140
1879-0887
1879-0887
DOI:10.1016/j.radonc.2024.110193