Accelerated Partial Breast Irradiation Using Multi-Catheter Brachytherapy for Selected Early-Stage Breast Cancer: Analysis of 377 Cases With 50 Months Median Follow-Up

Abstract

To report the feasibility, toxicity, cosmesis, and efficacy of accelerated partial breast irradiation (APBI) using interstitial multi-catheter high-dose-rate brachytherapy for early-stage breast cancer. Between March 2004 and June 2013, 377 selected patients with stage I-II breast cancer received APBI using multi-catheter brachytherapy following breast-conserving surgery. Eligibility criteria for the patient selection were based on the indications of the American Brachytherapy Society. The prescription dose was 34 Gy in 10 fractions, 3.4 Gy per fraction, twice a day, in intervals of more than 6 hours and was delivered to the tumor bed plus a 1-2 cm margin. The median follow-up time was 50.4 months. The median age of the patients was 59 years. The median tumor size was 1.3 cm. The local control rate was 97% (eleven local recurrence was detected). No local infection was observed. Acute and late skin reactions were rare and long-term cosmetic outcome was very good to excellent. APBI with interstitial multi-catheter high-dose-rate brachytherapy is feasible in selected patients with early-stage breast cancer. Local control and cosmesis were excellent with acceptable rates of acute and late toxicities.