Brachytherapy For Breast Cancer Research Articles

Preliminary report on ultrashort perioperative partial-breast irradiation with multicatheter interstitial brachytherapy for early-stage breast cancer.

Perioperative partial-breast irradiation (PBI) with multicatheter interstitial brachytherapy (MIB) is less invasive and more convenient than postoperative one. This study aimed to compare ultrashort perioperative MIB-PBI (uPBI) and conventional perioperative MIB-PBI (cPBI) performed during the same period of time. Inclusion criteria of the study were patients aged ≥ 40years and those with T0-2 (≤ 3cm), N0-mi, and negative margins on mammography. The locoregional recurrence (LRR) and toxicity rates were compared between uPBI at a dose of 25.2Gy in four fractions and cPBI at a dose of 32Gy in eight fractions. In total, 198 patients (151 with uPBI and 47 with cPBI) were evaluated. At a median follow-up of 20.1months, one (0.66%) patient in the uPBI group had LRR. The 2-year ipsilateral breast tumor recurrence-free survival rates of the uPBI and cPBI groups were 98.7% and 100%, respectively. The highest toxicity grades were grade 1 in 23 (15.2%) and grade 2 in 2 (1.3%) patients in the uPBI group, and grade 1 in 8 (17.0%) and grade 2 in 1 (2.1%) patient in the cPBI group. None of the patients in the two groups presented with grade 3 and higher toxicities. The toxicity rates between the two groups did not significantly differ. Further, 22 (14.6%) patients in the uPBI group and 8 (17.0%) in the cPBI group, and 3 (2.0%) patients in the uPBI group and 1 (2.1%) in the cPBI had acute and late toxicities, respectively. The timing of toxicity development between the two groups did not significantly differ. Although this preliminary report included a small sample size and had a short follow-up period, the local control and toxicity rates were similar between the uPBI and cPBI groups. Further research is warranted to investigate the ideal dose schedule of MIB-PBI.

Indian Brachytherapy Society consensus recommendations for brachytherapy in breast cancer

Indian Brachytherapy Society consensus recommendations for brachytherapy in breast cancer

Использование высокомощностной брахитерапии Ir-192 в лечении локализованного рака молочной железы

Thanks to the introduction of new screening programs, the emergence rate of novel anticancer drugs and the detection rate of early-stage breast cancer in Russia increase year by year. Organ preservation treatment, after which radiation therapy has to be performed, is the most common type of surgical treatment used in this cohort of patients. Today, various treatment methods are used, the most common is external beam radiation therapy, however, brachytherapy of breast cancer is also used.

Intraoperative Radiation Therapy Delivered by Brachytherapy in Breast Cancer: An Interim Analysis of a Phase 2 Trial

PurposeIntraoperative breast cancer radiotherapy (IORT) offers an alternative to external beam radiotherapy (EBRT) after breast-conserving surgery (BCS). The Intraoperative brachytherapy (IOBT) trial applies high dose rate (HDR) brachytherapy with a new applicator prototype as IORT after BCS. In this interim analysis of the IOBT trial, we present the oncological safety and toxicity of the method MethodsEligible patients were women, ≥ 50 years old with an unifocal nonlobular, estrogen-receptor-positive, HER2-negative breast cancer, cN0, ≤ 3 cm, treated with BCS and sentinel node biopsy (SNB). Toxicity was registered according to the LENT-SOMA scale. Cumulative incidence of local (LR) and regional recurrence (RR) were calculated through cumulative incidence function whereas overall survival (OS) was illustrated through Kaplan–Meier curve. ResultsUntil February 2023, 155 women (median age 68 years) were included in the trial. Twenty-nine women (18.7%) received supplemental EBRT, mostly due to positive SNB. Three-year cumulative incidence of LR and RR were 1.0% (CI 95 % 0.1%-2.3%) and 2.1% (CI 95% 0.8%-4.2%) respectively. Five- year cumulative incidence of LR and RR were 3.9% (CI 95% 1.8%-6.4%) and 2.1% (CI 95% 0.8%-4.2%) respectively. Five-year OS was 96.3% (CI 95% 93.6%-98.4%). Side effects were limited, low grade, and transient. ConclusionAcknowledging the short median follow-up time at interim analysis, our initial results indicate that delivering IORT through HDR brachytherapy in carefully selected breast cancer patients is feasible and oncological safe so far. A long-term follow-up is essential to confirm the initial results.

Thermally boosted interstitial high-dose-rate brachytherapy in high-risk early-stage breast cancer conserving therapy - large cohort long-term results.

Early-stage high-risk breast cancer (BC) is standardly treated with breast-conserving therapy (BCT), combined with systemic therapy and radiotherapy (RT) ± tumor bed boost, e.g., with interstitial high-dose-rate brachytherapy (HDR-BT). To improve local recurrence rate (LRR), BT radiosensitization (thermal boost, TB) with interstitial microwave hyperthermia (MWHT) may be an option. The paper aims to report a retrospective single-institutional study on 5- and 10-year local control (LC), distant metastasis-free survival (DMFS), disease-free survival (DFS), overall survival (OS), cosmetic outcome (CO), and late toxicity (fibrosis, fat necrosis) after thermally enhanced HDR-BT boost to the BC tumor bed. In 2006-2018, 557 early-stage (I-IIIA) high-risk BC patients were treated with BCT. If indicated, they were administered systemic therapy, then referred for 40.0-50.0 Gy whole breast irradiation (WBI) and 10 Gy interstitial HDR-BT boost (group A). Eligible patients had a single MWHT session preceding BT (group B). Based on present risk factors (RF), medium-risk (1-2 RF) and high-risk subgroups (≥ 3 RF) were formed. Patients were standardly checked, and control mammography (MMG) was performed yearly. Breast cosmesis (Harvard scale) and fibrosis were recorded. LC, DMFS, DFS, and OS were statistically analyzed. Out of 557 patients aged 57 years (26-84), 364 (63.4%) had interstitial HDR-BT boost (group A), and 193 (34.6%) were preheated with MWHT (group B). Patients in group B had a higher clinical stage and had more RFs. The median follow-up was 65.9. Estimated 5-year and 10-year LC resulted in 98.5% and 97.5%, respectively. There was no difference in LC, DMFS, DFS, and OS between groups A and B and between extracted high-risk subgroups A and B. Five- and ten-year OS probability was 95.4% and 88.0%, respectively, with no difference between groups A and B. Harvard criteria-based CO assessment revealed good/excellent cosmesis in 74.9-79.1%. Tumor bed hardening was present in 40.1-42.2%. Asymptomatic fat necrosis-related macrocalcifications were detected in 15.6%, more frequently in group B (p = 0.016). Thermally boosted or not, HDR-BT was locally highly effective as part of combined treatment. Five- and ten-year LC, DMFS, DFS, and OS were high and equally distributed between the groups, although TB was prescribed in more advanced one with more RFs. TB did not influence CO and fibrosis. TB added to late toxicity regarding asymptomatic fat necrosis detected on MMG.

MSOR10 Presentation Time: 5:30 PM: Ultra-Accelerated Perioperative High Dose Rate Brachytherapy for Early Breast Cancer, Preliminary Results from a Phase II Trial

MSOR10 Presentation Time: 5:30 PM: Ultra-Accelerated Perioperative High Dose Rate Brachytherapy for Early Breast Cancer, Preliminary Results from a Phase II Trial

Long-term outcomes of intraoperatively-placed applicator brachytherapy for rapid completion of breast conserving treatment: An analysis of a prospective registry data.

To evaluate the long-term outcome of accelerated partial breast irradiation utilizing intraoperatively placed applicator-based brachytherapy (ABB) in early-stage breast cancer. From our prospective registry, 223 patients with pTis-T2, pN0/pN1mic breast cancer were treated with ABB. The median treatment duration including surgery and ABB was 7days. The prescribed doses were 32Gy/8 fx BID (n=25), 34Gy/10 fx BID (n=99), and 21Gy/3 fx QD (n=99). Endocrine therapy (ET) adherence was defined as completion of planned ET or≥80% of the follow-up (FU) period. Cumulative incidence of ipsilateral breast tumor recurrence (IBTR) was estimated and influencing factors for IBTR-free survival rate (IBTRFS) were analyzed. 218/223 patients had hormone receptor-positive tumors, including 38 (17.0%) with Tis and 185 (83.0%) with invasive cancer. After a median FU of 63months, 19 (8.5%) patients had recurrence [17 (7.6%) with an IBTR]. Rates of 5-year IBTRFS and DFS were 92.2% and 91.1%, respectively. The 5-year IBTRFS rates were significantly higher for post-menopausal women (93.6% vs. 66.4%, p=0.04), BMI<30kg/m2 (97.4% vs. 88.1%, p=0.02), and ET-adherence (97.5% vs. 88.6%, p=0.02). IBTRFS did not differ with dose regimens. Postmenopausal status, BMI<30kg/m2, and ET- adherence predicted favorable IBTRFS. Our results highlight the importance of careful patient selection for ABB and encouragement of ET compliance.

Development, implementation, and results of a simulation-based hands-on brachytherapy workshop for medical students

PurposeThe new Medical Licensing Regulations 2025 (Ärztliche Approbationsordnung, ÄApprO) require the development of competence-oriented teaching formats. In addition, there is a great need for high-quality teaching in the field of radiation oncology, which manifests itself already during medical school. For this reason, we developed a simulation-based, hands-on medical education format to teach competency in performing accelerated partial breast irradiation (APBI) with interstitial multicatheter brachytherapy for early breast cancer. In addition, we designed realistic breast models suitable for teaching both palpation of the female breast and implantation of brachytherapy catheters.MethodsFrom June 2021 to July 2022, 70 medical students took part in the hands-on brachytherapy workshop. After a propaedeutic introduction, the participants simulated the implantation of single-lead catheters under supervision using the silicone-based breast models. Correct catheter placement was subsequently assessed by CT scans. Participants rated their skills before and after the workshop on a six-point Likert scale in a standardized questionnaire.ResultsParticipants significantly improved their knowledge-based and practical skills on APBI in all items as assessed by a standardized questionnaire (mean sum score 42.4 before and 16.0 after the course, p < 0.001). The majority of respondents fully agreed that the workshop increased their interest in brachytherapy (mean 1.15, standard deviation [SD] 0.40 on the six-point Likert scale). The silicone-based breast model was found to be suitable for achieving the previously defined learning objectives (1.19, SD 0.47). The learning atmosphere and didactic quality were rated particularly well (mean 1.07, SD 0.26 and 1.13, SD 0.3 on the six-point Likert scale).ConclusionThe simulation-based medical education course for multicatheter brachytherapy can improve self-assessed technical competence. Residency programs should provide resources for this essential component of radiation oncology. This course is exemplary for the development of innovative practical and competence-based teaching formats to meet the current reforms in medical education.

MSPP03 Presentation Time: 4:20 PM: Decline of Complex Brachytherapy Procedures and Providers Despite Ongoing Need: An Analysis of US Brachytherapy Services from 2013-2019 Based on Medicare Data

<h3>Purpose</h3> According to the American Society of Radiation Oncology (ASTRO), there are approximately 5,000 practicing radiation oncologists (RO) in the United States (US). It is unknown, however, how many of these RO practice brachytherapy. We used claims from Center for Medicare and Medicaid services (CMS) to estimate the number of RO who provide brachytherapy and examine trends in the number of patients that receive brachytherapy. <h3>Materials and Methods</h3> Using Medicare Provider Utilization and Payment Data (the Physician and Other Supplier Public Use File (POSPUF) publically available data set), we identified unique procedural codes related to brachytherapy practice in prostate, gynecologic (GYN), breast, and ocular cancers from 2013 to 2019. For each disease site, the total of rendering providers, beneficiaries, and services were identified. The number of patients who received brachytherapy and the number of procedures per 100,000 Medicare enrollees were also calculated. Yearly trends in services and number of providers were then developed. Trends were tested using the Kendall Tau rank correlation using R version 3.6.3. <h3>Results</h3> For prostate brachytherapy, the total number of patients receiving brachytherapy (6145 in 2013 to 5695 in 2019) and procedures performed (8609 to 7862) remained steady over the study period (p=0.76), while the number of providers dropped significantly by 32% (1981 to 1361, p=0.003). The number of providers providing brachytherapy remained steady for intrauterine implants (663 to 625, p=0.37), while the number of patients (4.3 to 3.2 per 100,000 enrollee, p=0.02) and performed procedures decreased (13.4 to 10.4 per 100,000 enrollee, p=0.02) from 2013 to 2019. There was a non-significant trend in decline of total patients (12%) and services (8.6%) over time (p=0.07). For intravaginal implants, total services increased by 45% (p=0.007) and patients increased by 36% (p=0.007). The number of patients and procedures per 100,000 Medicare enrollee (12.7 to 14.7, p=0.035 and 40.8 to 50.1, p=0.007, respectively) as well as the number of providers performing intravaginal implants increased by 31% (1070 to 1403, p=0.007) from 2013-2019. For breast, total providers decreased by 56.4%, as well as patients (-51.4%) and procedures (-52%, p=0.003, for all metrics). For ocular implants, the total number of patients and services remained steady (p=0.37 and p=0.37), while those performing decreased by 13% (p=0.048). <h3>Discussion</h3> There is an overall decline of providers performing brachytherapy for prostate and ocular cancers, although the number of procedures and patients remain the same. There is a decline in the number of RO providing and patients receiving brachytherapy for breast cancer. While the number of providers performing intrauterine implants remains steady, there is an increase in those performing vaginal implants, suggesting more RO are performing less complicated intracavitary vaginal implants. A decrease of patients requiring intrauterine implants may reflect either decreased indications (such as in cervical cancer with decreased incidence due to better screening and vaccination against Human Papillomavirus) or decreased utilization by providers in favor of other methods, such as with stereotactic body radiotherapy (SBRT). A potential limitation of this study includes the inability to identify individual providers who may be included in multiple disease categories and thus, overestimating the total number of providers. These data underlie the need for increased brachytherapy training to ensure that utilization rates for all forms of brachytherapy match the clinical indications.

Long-Term Outcome of Novel Intraoperatively-Placed Brachytherapy for Rapid Completion of Breast Conserving Therapy

<h3>Purpose/Objective(s)</h3> To evaluate the long-term outcome of accelerated partial breast irradiation utilizing an intraoperatively-placed applicator-based brachytherapy (ABB) in early-stage breast cancer. <h3>Materials/Methods</h3> We identified 226 patients with pTis-T2, pN0/pN1mic breast cancer treated with ABB at our institution 10/2012-9/2019 from our prospective registry, of whom 223 had follow-ups (FU) at our institution and form the basis of this analysis. ABB initiated at a median of two days following operation. The median treatment duration including surgery and ABB completion was 7 days. The prescribed dose regimens were as follows: 32 Gy in 8 twice-daily fractions (n=25), 34 Gy in 10 twice-daily fractions (n=99), and 21 Gy in 3 once-daily fractions (n=99). After completion of ABB, adjuvant endocrine treatment (ET) was prescribed for patients with hormone receptor-positive (HR+) tumors. ET adherence was defined completion of planned ET course or ≥ 80% of FU period. Cumulative incidence of ipsilateral breast tumor recurrence (IBTR) and disease-free survival (DFS) were estimated using Gray's test, with death as a competing risk. Variables influencing for IBTR-free survival rate (IBTRFS) were analyzed by Fine-Gray model. <h3>Results</h3> 221/226 patients had HR+ tumors, including 38 (17.0%) with Tis and 185 (83.0%) with invasive cancers. After a median follow-up of 63 months (interquartile range, 42 – 81), 20 (9.0%) patients recurred, including 18 (8.1%) with an IBTR. The site of recurrence was IBTR alone in 16 patients, simultaneous IBTR/regional/distant metastasis (DM) in 2, regional recurrence in 1, and DM in 1 patient. 5-year IBTRFS and DFS were 91.6% and 91.1%, respectively. IBTR was significantly lower for post-menopausal women and those adherents to prescribed ET: menopause (HR 0.26, 95% CI 0.09 – 0.76, p < 0.01) and ET adherence (HR 0.19, 95% CI 0.04 – 0.80, p = 0.01). The 5-year IBTRFS for post-menopausal patients (n=204) was significantly higher than for non-menopausal women (n=19) (93.5% vs. 65.3%, p < 0.01). The 5-year IBTRFS in ET-adherent patients (n=96) was significantly better than for ET-non-adherent patients (n=127) (97.5% vs. 87.7%, p = 0.01). IBTRFS was not different by ABB regimens (HR 0.61, 95% CI 0.28 – 1.33, p = 0.21). <h3>Conclusion</h3> ABB is an attractive option for patients with favorable early-stage breast cancer. Post-menopausal status and adherence to prescribed ET predicted favorable outcomes in terms of IBTRFS after ABB. Our results highlight the importance of multidisciplinary counseling with careful patient selection for ABB and encouragement of ET compliance.

Ultra-Accelerated Photons, Protons or Brachytherapy for Favorable Early Breast Cancer: Long-Term Results of a 3-Fraction Partial Breast Irradiation Trial

<h3>Purpose/Objective(s)</h3> To report long-term outcomes of a novel partial breast irradiation (PBI) regimen. We hypothesized that condensing treatment to 3 fractions and reducing total dose could improve the therapeutic ratio based on emerging evidence that breast cancer (BC) is more sensitive than surrounding normal tissues to high dose fractions. <h3>Materials/Methods</h3> We conducted a phase 2 trial of photon, proton, or brachytherapy PBI. Technique was selected at physician and patient discretion. Eligible women were age ≥ 50 years and s/p lumpectomy with negative sentinel nodes for estrogen receptor positive (ER+) invasive BC without preoperative chemotherapy or any ductal carcinoma in-situ (DCIS) measuring ≤ 2.5 cm. The regimen was designed to have comparable biologically effective dose as 40 Gy in 15 fractions, assuming an α/β ratio of 3.5. Photon and proton target volumes were post-operative tumor bed plus 1 cm and a 3 mm setup uncertainty margin and prescribed 21.9 Gy (RBE) in 3 fractions. Intracavitary brachytherapy was prescribed 21 Gy in 3 daily fractions. Radiotherapy was administered on 3 consecutive business days. Primary outcome was nurse-assessed adverse (fair/poor) cosmesis by 4-point Harvard scale at 3 years versus pre-PBI. Patients completed quality of life and self-reported cosmesis surveys. Adverse events were assessed using CTCAE, v 4.0. <h3>Results</h3> Between 2015 and 2017, 162 eligible patients were treated: photons in 56, protons in 49, and brachytherapy in 57. Median patient age was 67 years. 79% had invasive BC (all ER+) and 22% had DCIS (83% ER+). Median tumor size was 1.1 cm. Median Ki67 was 10% (IQR 6-17) and grade was 2-3 in 62%. The median of the mean heart/ipsilateral lung doses were photons 0.1/1.6 Gy, protons <0.001/0.1 Gy, and brachytherapy 0.5/0.9 Gy. 55% received endocrine therapy. The proportion of patients with adverse cosmesis (by RN assessment) was 14.4% pre-PBI, 4.0% at 3 years, and 5.6% at last follow-up (at median 4.9 years) with six patients (3.8%, 3 photon, 3 brachytherapy) experiencing cosmetic worsening. 92.7%, 95.9%, and 94.7%, of patients in the photon, proton, and brachytherapy cohorts had good or excellent cosmesis at last follow-up. The proportion with adverse cosmesis by self-report was 0% pre-PBI and 2.0% at 3 years. Four patients developed local recurrence (1 photons, 2 protons, 1 brachytherapy). 5-year local recurrence-free, progression-free, and overall survival were 97.9%, 95.1%, and 96.9%, respectively. There were 2 treatment related grade ≥2 adverse events (grade 2 fibrosis and grade 2 seroma, both brachytherapy associated), and no evidence of deterioration in patient-reported pain, fatigue, breast related or overall quality of life. <h3>Conclusion</h3> Ultra-accelerated 3-fraction PBI exquisitely spared normal tissues, was associated with favorable cosmetic outcomes, disease control, and excellent tolerability. This is an attractive option for small node-negative ER+ BC and DCIS.

Thermal Boost Combined with Interstitial Brachytherapy in Early Breast Cancer Conserving Therapy-Initial Group Long-Term Clinical Results and Late Toxicity.

(1) In breast-conserving therapy (BCT), adjuvant radiation, including tumor bed boost, is mandatory. Safely delivered thermal boost (TB) based on radio-sensitizing interstitial microwave hyperthermia (MWHT) preceding standard high-dose-rate (HDR) brachytherapy (BT) boost has the potential for local control (LC) improvement. The study is to report the long-term results regarding LC, disease-free survival (DFS), overall survival (OS), toxicity, and cosmetic outcome (CO) of HDR-BT boost ± MWHT for early breast cancer (BC) patients treated with BCT. (2) In the years 2006 and 2007, 57 diverse stages and risk (IA-IIIA) BC patients were treated with BCT ± adjuvant chemotherapy followed by 42.5–50.0 Gy whole breast irradiation (WBI) and 10 Gy HDR-BT boost. Overall, 25 patients (group A; 43.9%) had a BT boost, and 32 (group B; 56.1%) had an additional pre-BT single session of interstitial MWHT on a tumor bed. Long-term LC, DFS, OS, CO, and late toxicity were evaluated. (3) Median follow-up was 94.8 months (range 1.1–185.5). LC was 55/57, or 96.5% (1 LR in each group). DFS was 48/57, or 84.2% (4 failures in group A, 5 in B). OS was 46/57, or 80.7% (6 deaths in group A, 5 in B). CO was excellent in 60%, good in 36%, and satisfactory in 4% (A), and in 53.1%, 34.4%, and 9.4% (B), respectively. One poor outcome was noted (B). Late toxicity as tumor bed hardening occurred in 19/57, or 33.3% of patients (9 in A, 10 in B). In one patient, grade 2 telangiectasia occurred (group A). All differences were statistically insignificant. (4) HDR-BT boost ± TB was feasible, well-tolerated, and highly locally effective. LC, DFS, and OS were equally distributed between the groups. Pre-BT MWHT did not increase rare late toxicity.

OC-0629 The use of hyaluronic acid hydrogel as a tumour bed marker in breast cancer brachytherapy.

OC-0629 The use of hyaluronic acid hydrogel as a tumour bed marker in breast cancer brachytherapy.

Retrospective review of three-fractioned accelerated partial breast irradiation

MethodsThis retrospective study evaluated patients who received three-fraction accelerated partial breast irradiation (APBI) via brachytherapy for breast cancer between January 2016 and April 2020. Inclusion criteria included age ≥18 years and early-stage unilateral breast cancer with negative lymph nodes. We evaluated acute toxicity (<6 weeks), late toxicity (≥6 weeks), and cosmetic outcomes. Frequencies of each variable were calculated. Cancer-specific outcomes were determined via the Kaplan-Meier method. ResultsThirty consecutive patients received three-fraction APBI of 2,250 cGy over 2 d. All cancers were stage T2 or less. Median time to last follow-up was 22 months. Local recurrence-free survival was 95.8% at 22 months. Seventeen (56.7%) patients reported an acute toxicity event. All were grade 1 except one patient with grade 2 (fatigue). No patient experienced ≥ grade 3 acute toxicity. One (3.3%) patient reported grade 3 late toxicity (tissue fibrosis). No patients had breast edema, fat necrosis, or non-healing wounds. There were no ≥ grade 3 cosmetic events. DiscussionThree-fraction APBI via brachytherapy was successful in preventing disease recurrence and death in this study, with still limited follow-up. Although acute and late toxicities or adverse cosmetic outcomes were seen, very few were grade 2 or higher and compare favorably to those reported in prior 10-fraction APBI studies. ConclusionsThis study provides early single institutional evidence that three-fraction APBI may become a feasible treatment alternative.

Interstitial high dose rate brachytherapy boost in early-stage breast cancer: deformable image registration for defining target volume

Purpose: optimization of the technique of additional irradiation of the removed tumor bed using high-dose brachytherapy for breast cancer. Material and Methods: the results of treatment of 28 patients diagnosed with breast cancer were analyzed. After surgical treatment and a course of external radiation therapy, all patients underwent additional irradiation of the removed tumor bed using high-dose brachytherapy. The assessment of the operation protocols, the data of the pathomorphological conclusion was carried out, and on the basis of pre- and postoperative CT images, the formation of irradiation fields for high-dose brachytherapy was carried out. Results: After deformable (nonrigid) registration of pre- and postoperative CT images of 28 patients, it was revealed that in 18 women (64.3% of cases) the location of interstitial markers and the primary tumor focus does not match topographically, which can cause incorrect formation of borders irradiation. In 35.7% of cases, radiopaque markers were located on the chest wall (on the pectoralis major muscle) when the primary tumor was located in the breast tissue. In 25% of cases, the markers were located cranial or caudal to the topography of the primary tumor focus. Label migration occurred in 3.6% of cases. In 35.7% of cases, the topography of the primary tumor node and marks completely coincided. Conclusions: The use of deformable (non-rigid) registration of pre- and postoperative CT images is a simpler method to determine the topography of the removed tumor bed, which subsequently leads to a more accurate formation of the clinical volume of irradiation.

SP-0262 Interstitial Salvage -brachytherapy for recurrent breast cancer of thoracic wall

SP-0262 Interstitial Salvage -brachytherapy for recurrent breast cancer of thoracic wall

PO-1146 Perioperative HDR brachytherapy for breast cancer, technique implementation in a single institution

PO-1146 Perioperative HDR brachytherapy for breast cancer, technique implementation in a single institution

PO-0228 Inverse versus forward optimisation methods in brachytherapy of breast, cervix and prostate cancer

PO-0228 Inverse versus forward optimisation methods in brachytherapy of breast, cervix and prostate cancer

Evaluation Absorbed Dose During the Breast Cancer Brachytherapy in Canine Phantom

Evaluation Absorbed Dose During the Breast Cancer Brachytherapy in Canine Phantom

OC-1035: Impact of choices in dosimetric calculation method for high dose rate brachytherapy of breast cancer

OC-1035: Impact of choices in dosimetric calculation method for high dose rate brachytherapy of breast cancer