Cosmetic results good, toxicity mild with accelerated partial-breast irradiation

As a treatment for early-stage breast cancer, accelerated partial-breast irradiation (APBI) with interstitial brachytherapy results in good to excellent cosmesis in nearly all patients and is associated with only mild toxicities, new research shows.

“These results of patients who received APBI with interstitial brachytherapy closely parallel the results from several single-institutional experiences along with a phase III randomized trial, all of which demonstrated its 5-year efficacy in selected patients,” lead author Dr. Peter Y. Chen and colleagues, from William Beaumont Hospital in Royal Oak, Michigan, note in the March issue of Cancer. The current findings are based on a study of 199 patients with stage I or II breast cancer who were treated with APBI between April 1993 and December 2001 at the authors’ institution. The APBI was applied to the tumor bed alone using low-dose-rate or high-dose-rate implants. The low-dose-rate treatment, an inpatient procedure, delivered 50 Gy over 96 hours; the high-dose-rate therapy was given as an outpatient procedure and delivered 32 or 34 Gy in 8 or 10 fractions, separated by 6 hours.The median follow-up period was 6.4 years. At long-term follow-up, 33% of cosmetic outcomes were excellent, 66% were good, and 1% were fair, the researchers state. Breast pain, edema, erythema, and hyperpigmentation were common findings following APBI, but all decreased over time, the report indicates. After increasing until the 2-year mark, breast fibrosis and hypopigmentation stabilized. Infections were generally mild and were largely confined to the first month after APBI, the report indicates.”These extended time-interval morbidity and outcome data from 199 selected patients who received treatment at our institution with APBI by interstitial brachytherapy document mild long-term toxicities, the majority of which diminish or reach a plateau over time,” the authors note. Moreover, cosmetic outcomes are good or excellent in nearly all patients.(Source: Cancer 2006;106:991-999: Reuters Health: Oncolink: March 2006.)