Accelerated partial breast irradiation with interstitial brachytherapy as second conservative treatment for ipsilateral breast tumour recurrence: multicentric study of the GEC-ESTRO Breast Cancer Working Group

Hannoun-Levi, Jean-Michel; Resch, Alexandra; Gal, Jocelyn; Kauer-Dorner, Daniela; Strnad, Vratislav; Niehoff, Peter; Loessl, Kristina; Kovács, Gyoergy; Van Limbergen, Erick; Polgár, Csaba; GEC-ESTRO Breast Cancer Working Group, on behalf of the (2013). Accelerated partial breast irradiation with interstitial brachytherapy as second conservative treatment for ipsilateral breast tumour recurrence: multicentric study of the GEC-ESTRO Breast Cancer Working Group. Radiotherapy and oncology, 108(2), pp. 226-231. Elsevier 10.1016/j.radonc.2013.03.026

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PURPOSE

To analyse the clinical outcome after salvage lumpectomy and multi-catheter brachytherapy (MCB) for ipsilateral breast tumour recurrence (IBTR).

MATERIAL AND METHODS

Between 09/00 and 09/10, 217 patients presenting an IBTR underwent lumpectomy and MCB (low, pulsed, or high-dose rate). Survival rates without second local recurrence (2nd LR), distant metastasis (DM), and overall survival (OS) were analysed as well as late effects and cosmetic results. Univariate and multivariate analyses (MVA) based on IBTR data were performed to find prognostic factors for 2nd LR, DM, and OS.

RESULTS

Median follow-up after the IBTR was 3.9 years [range: 1.1-10.3]. Five and 10-year actuarial 2nd LR rates were 5.6% [range: 1.5-9.5] and 7.2% [range: 2.1-12.1], respectively. Five and 10-year actuarial DM rates were 9.6% [range: 5.7-15.2] and 19.1% [range: 7.8-28.3], respectively. Five and 10-year actuarial OS rates were 88.7% [range: 83.1-94.8] and 76.4% [range: 66.9-87.3], respectively. In MVA, histological grade was prognostic factor for 2nd LR (p=0.008) and OS (p=0.02); while tumour size was prognostic factor for DM (p=0.03). G3-4 complication rate was 11%. Excellent/good cosmetic result was achieved in 85%.

CONCLUSION

This study suggests that in case of IBTR, lumpectomy plus MCB is feasible and effective in preventing 2nd LR with an OS rate at least equivalent to those achieved with salvage mastectomy.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology
UniBE Contributor:	Lössl, Kristina
Subjects:	600 Technology > 610 Medicine & health
ISSN:	0167-8140
Publisher:	Elsevier
Language:	English
Submitter:	Beatrice Scheidegger
Date Deposited:	23 Apr 2014 11:44
Last Modified:	05 Dec 2022 14:29
Publisher DOI:	10.1016/j.radonc.2013.03.026
PubMed ID:	23647758
Uncontrolled Keywords:	Brachytherapy, Breast cancer, Conservative treatment, Local recurrence
URI:	https://boris.unibe.ch/id/eprint/43537