203 External irradiation and interstitial LDR brachytherapy in the treatment of early breast cancer

Abstract

The combined method of conservative surgery, using local tumor excision and axillary node dissection, plus irradiation, has been used in our department since 1983–1994 (190 patients with early breast cancer): 80 (42.1%) patients received boost therapy with Cr-137 implants, 65 (34.2%) had external beam therapy and 45 (23.6%) no boost. To the first group of patients a dose of 45–50 Gy was given to the whole breast by external radiotherapy, and the previous tumor area was boosted by an interstitial implant with Caesium-137 LDR (about 20 Gy in fraction). External beam irradiation was given to the whole breast 10-14 days later. In this group we found a local recurrence rate of 5.2% (4/80). The second group of patients had external boost of 14–15 Gy (7 Gy × 2), given by electrons in the energy range of 9–12 Mev. An additional dose of 74–80 Gy in three fractions daily (10 Gy × fraction), was given to these patients in cases of central and media breast cancer. We used a microSelectron-HDR for intraoperative brachytherapyand irradiated the parasternal lymph node chain. The local recurrence rate was 7.6 (5/65). And in a third group of 45 patients the entire breast was irradiated by only 50 Gy without boost. For this group there was a recurrence rate of 13.3% (6/45). The combined method of conservative surgery, using local tumor excision and axillary node dissection, plus irradiation, has been used in our department since 1983–1994 (190 patients with early breast cancer): 80 (42.1%) patients received boost therapy with Cr-137 implants, 65 (34.2%) had external beam therapy and 45 (23.6%) no boost. To the first group of patients a dose of 45–50 Gy was given to the whole breast by external radiotherapy, and the previous tumor area was boosted by an interstitial implant with Caesium-137 LDR (about 20 Gy in fraction). External beam irradiation was given to the whole breast 10-14 days later. In this group we found a local recurrence rate of 5.2% (4/80). The second group of patients had external boost of 14–15 Gy (7 Gy × 2), given by electrons in the energy range of 9–12 Mev. An additional dose of 74–80 Gy in three fractions daily (10 Gy × fraction), was given to these patients in cases of central and media breast cancer. We used a microSelectron-HDR for intraoperative brachytherapyand irradiated the parasternal lymph node chain. The local recurrence rate was 7.6 (5/65). And in a third group of 45 patients the entire breast was irradiated by only 50 Gy without boost. For this group there was a recurrence rate of 13.3% (6/45).