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Int J Radiat Oncol Biol Phys. 2015 Nov 1;93(3):614-21. doi: 10.1016/j.ijrobp.2015.07.2266. Epub 2015 Jul 21.

Report on the Clinical Outcomes of Permanent Breast Seed Implant for Early-Stage Breast Cancers.

Author information

1
Radiation Oncology Department, University of Toronto at Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Radiation Oncology Department, Erasmus Medical Center Cancer Institute, Rotterdam, The Netherlands. Electronic address: j.p.pignol@erasmusmc.nl.
2
Department of Radiation Medicine, The Ottawa Hospital Cancer Centre, Ottawa, Ontario, Canada.
3
Department of Radiation Oncology, BC Cancer Agency Center for the Southern Interior, Kelowna, British Columbia, Canada.
4
Radiation Oncology Department, University of Toronto at Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
5
Radiation Oncology Department, BC Cancer Agency Vancouver Island Centre, Victoria, British Columbia, Canada.
6
Imaging Division, University Medical Centre Utrecht, Utrecht, The Netherlands.

Abstract

PURPOSE:

Permanent breast seed implant is an accelerated partial breast irradiation technique realizing the insertion of (103)Pd seeds in the seroma after lumpectomy. We report the 5-year efficacy and tolerance for a cohort, pooling patients from 3 clinical trials.

METHODS AND MATERIALS:

The trials accrued postmenopausal patients with infiltrating ductal carcinoma or ductal carcinoma in situ ≤3 cm and clear surgical margins, who were node negative, and had a planning target volume <120 cm(3). The outcomes included overall and disease-free survival and local and contralateral recurrence at 5 years. The true local recurrence rate was compared using 2-tailed paired t tests for estimates calculated using the Tufts University ipsilateral breast tumor recurrence and Memorial Sloan Kettering ductal carcinoma in situ nomograms.

RESULTS:

The cohort included 134 patients, and the observed local recurrence rate at a median follow-up period of 63 months was 1.2% ± 1.2%, similar to the estimate for whole breast irradiation (P=.23), significantly better than for surgery alone (relative risk 0.27; P<.001), and significantly lower than contralateral recurrence (relative risk 0.33; P<.001). The 5-year overall survival rate was 97.4% ± 1.9%, and the disease-free survival rate was 96.4% ± 2.1%. At 2 months, 42% of the patients had erythema, 20% induration, and 16% moist desquamation. The rate of mainly grade 1 telangiectasia was 22.4% at 2 years and 24% at 5 years. The rate of asymptomatic induration was 23% at 2 years and 40% at 5 years.

CONCLUSIONS:

The 5-year data suggest that permanent breast seed implantation is a safe accelerated partial breast irradiation option after lumpectomy for early-stage breast cancer with a tolerance profile similar to that of whole breast irradiation.

PMID:
26461003
DOI:
10.1016/j.ijrobp.2015.07.2266
[Indexed for MEDLINE]

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