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

Abstract

Purpose: Permanent breast seed implant is an accelerated partial breast irradiation technique realizing the insertion of {sup 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{sup 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 ratemore » 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.« less

Authors:
 [1];  [2];  [3];  [4];  [1];  [5];  [6]
  1. Radiation Oncology Department, University of Toronto at Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada)
  2. (Netherlands)
  3. Department of Radiation Medicine, The Ottawa Hospital Cancer Centre, Ottawa, Ontario (Canada)
  4. Department of Radiation Oncology, BC Cancer Agency Center for the Southern Interior, Kelowna, British Columbia (Canada)
  5. Radiation Oncology Department, BC Cancer Agency Vancouver Island Centre, Victoria, British Columbia (Canada)
  6. Imaging Division, University Medical Centre Utrecht, Utrecht (Netherlands)
Publication Date:
OSTI Identifier:
22644985
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 93; Journal Issue: 3; Other Information: Copyright (c) 2015 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRACHYTHERAPY; CARCINOMAS; CLINICAL TRIALS; IRRADIATION; MAMMARY GLANDS; PALLADIUM 103; PATIENTS; RADIATION SOURCE IMPLANTS

Citation Formats

Pignol, Jean-Philippe, E-mail: j.p.pignol@erasmusmc.nl, Radiation Oncology Department, Erasmus Medical Center Cancer Institute, Rotterdam, Caudrelier, Jean-Michel, Crook, Juanita, McCann, Claire, Truong, Pauline, and Verkooijen, Helena A. Report on the Clinical Outcomes of Permanent Breast Seed Implant for Early-Stage Breast Cancers. United States: N. p., 2015. Web. doi:10.1016/J.IJROBP.2015.07.2266.
Pignol, Jean-Philippe, E-mail: j.p.pignol@erasmusmc.nl, Radiation Oncology Department, Erasmus Medical Center Cancer Institute, Rotterdam, Caudrelier, Jean-Michel, Crook, Juanita, McCann, Claire, Truong, Pauline, & Verkooijen, Helena A. Report on the Clinical Outcomes of Permanent Breast Seed Implant for Early-Stage Breast Cancers. United States. doi:10.1016/J.IJROBP.2015.07.2266.
Pignol, Jean-Philippe, E-mail: j.p.pignol@erasmusmc.nl, Radiation Oncology Department, Erasmus Medical Center Cancer Institute, Rotterdam, Caudrelier, Jean-Michel, Crook, Juanita, McCann, Claire, Truong, Pauline, and Verkooijen, Helena A. Sun . "Report on the Clinical Outcomes of Permanent Breast Seed Implant for Early-Stage Breast Cancers". United States. doi:10.1016/J.IJROBP.2015.07.2266.
@article{osti_22644985,
title = {Report on the Clinical Outcomes of Permanent Breast Seed Implant for Early-Stage Breast Cancers},
author = {Pignol, Jean-Philippe, E-mail: j.p.pignol@erasmusmc.nl and Radiation Oncology Department, Erasmus Medical Center Cancer Institute, Rotterdam and Caudrelier, Jean-Michel and Crook, Juanita and McCann, Claire and Truong, Pauline and Verkooijen, Helena A.},
abstractNote = {Purpose: Permanent breast seed implant is an accelerated partial breast irradiation technique realizing the insertion of {sup 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{sup 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.},
doi = {10.1016/J.IJROBP.2015.07.2266},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 93,
place = {United States},
year = {2015},
month = {11}
}