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

详细信息    查看全文

• 作者：Jean-Philippe Pignol ; MD ; PhD^&lowast ; ; ^&dagger ; ; ^{j.p.pignol@erasmusmc.nl" class="auth_mail" title="E-mail the corresponding author} ; Jean-Michel Caudrelier ; MD^&Dagger ; ; Juanita Crook ; MD^§ ; ; Claire McCann ; PhD^&lowast ; ; Pauline Truong ; MD ; MSc^|| ; Helena A. Verkooijen ; MD ; PhD^¶ ;
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2015
• 出版时间：1 November 2015
• 年：2015
• 卷：93
• 期：3
• 页码：614-621
• 全文大小：1071 K

文摘

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

d="absSec_2">Methods and Materials

d="abspara0015">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 cm³. 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.

d="absSec_3">Results

d="abspara0020">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.

d="absSec_4">Conclusions

d="abspara0025">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.