Interstitial High-Dose Rate (HDR) Brachytherapy: A Risk Adapted Treatment for Breast Cancer

Purposea risk adapted evaluation of our results using interstitial HDR brachytherapy (HDT-BT) as a boost or as accelerated partial breast irradiation (APBI).Material and MethodsFollowing GEC-ESTRO criteria, patients with low risk of recurrence were treated by exclusive HDR brachytherapy APBI (32Gy, 8 fractions of 4Gy). Those with intermediate or high risk were initially referred to HDR (8Gy in tumor bed) and external-beam radiotherapy (EBRT, 50 Gy).275 breast cancer patients, between 1999-2014, have been included, with a mean follow-up of 65 months (4-179).ResultsAccording to GEC-ESTRO risk classification 41% patients were classified as low risk, 21%, as intermediate and 38% as high risk. Most of low risk cases were treated by APBI (81,7%) and most of high risk received combined treatment (64,4%). Intermediate risk patients received either APBI or combined treatment. Mean age at diagnoses was 61,67 years (24-92). Reasons for favouring APBI instead of combined Approach compared with initial designed treatment schedule in intermediate and high risk cases, were due to individual patients’ needs (as age >70 years and distance from facility). Local disease free survival was, in the low risk group 100% at 5 and 10 years, in the intermediate risk group 96,2% and 87,4% and in the high risk group 95,6% and 92,4% at 5 and 10 years respectively.ConclusionsPatient individualization (age and social situation) should be taken in account when prescribing the treatment schedule. Risk adapted HDR brachytherapy seems to be an adequate approach in breast cancer conservative treatment. Purposea risk adapted evaluation of our results using interstitial HDR brachytherapy (HDT-BT) as a boost or as accelerated partial breast irradiation (APBI). a risk adapted evaluation of our results using interstitial HDR brachytherapy (HDT-BT) as a boost or as accelerated partial breast irradiation (APBI). Material and MethodsFollowing GEC-ESTRO criteria, patients with low risk of recurrence were treated by exclusive HDR brachytherapy APBI (32Gy, 8 fractions of 4Gy). Those with intermediate or high risk were initially referred to HDR (8Gy in tumor bed) and external-beam radiotherapy (EBRT, 50 Gy).275 breast cancer patients, between 1999-2014, have been included, with a mean follow-up of 65 months (4-179). Following GEC-ESTRO criteria, patients with low risk of recurrence were treated by exclusive HDR brachytherapy APBI (32Gy, 8 fractions of 4Gy). Those with intermediate or high risk were initially referred to HDR (8Gy in tumor bed) and external-beam radiotherapy (EBRT, 50 Gy).275 breast cancer patients, between 1999-2014, have been included, with a mean follow-up of 65 months (4-179). ResultsAccording to GEC-ESTRO risk classification 41% patients were classified as low risk, 21%, as intermediate and 38% as high risk. Most of low risk cases were treated by APBI (81,7%) and most of high risk received combined treatment (64,4%). Intermediate risk patients received either APBI or combined treatment. Mean age at diagnoses was 61,67 years (24-92). Reasons for favouring APBI instead of combined Approach compared with initial designed treatment schedule in intermediate and high risk cases, were due to individual patients’ needs (as age >70 years and distance from facility). Local disease free survival was, in the low risk group 100% at 5 and 10 years, in the intermediate risk group 96,2% and 87,4% and in the high risk group 95,6% and 92,4% at 5 and 10 years respectively. According to GEC-ESTRO risk classification 41% patients were classified as low risk, 21%, as intermediate and 38% as high risk. Most of low risk cases were treated by APBI (81,7%) and most of high risk received combined treatment (64,4%). Intermediate risk patients received either APBI or combined treatment. Mean age at diagnoses was 61,67 years (24-92). Reasons for favouring APBI instead of combined Approach compared with initial designed treatment schedule in intermediate and high risk cases, were due to individual patients’ needs (as age >70 years and distance from facility). Local disease free survival was, in the low risk group 100% at 5 and 10 years, in the intermediate risk group 96,2% and 87,4% and in the high risk group 95,6% and 92,4% at 5 and 10 years respectively. ConclusionsPatient individualization (age and social situation) should be taken in account when prescribing the treatment schedule. Risk adapted HDR brachytherapy seems to be an adequate approach in breast cancer conservative treatment. Patient individualization (age and social situation) should be taken in account when prescribing the treatment schedule. Risk adapted HDR brachytherapy seems to be an adequate approach in breast cancer conservative treatment.