Brachytherapy · 2025
Multicatheter interstitial brachytherapy-delivered APBI as single-fraction treatment in older breast cancer patients: A feasibility retrospective institutional analysis.
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van der Elzen Catarina, Correia Diana, Garcia Sofia, Fernandes Pedro, Pereira Alexandre, Pinto Sara, Maçães Marina, Lima Inês, Trigo Lurdes
Аннотация
PURPOSE: Accelerated partial breast irradiation (APBI) has emerged as an alternative to whole-breast irradiation (WBI) for selected patients with low-risk early breast cancer (EBC). While external beam APBI techniques are widely available, multicatheter interstitial brachytherapy (MIB) offers superior conformity and reduced normal tissue exposure. We evaluated the feasibility, toxicity, and early outcomes of an ultra-hypo fractionated approach using a single-fraction MIB-APBI in older patients.
METHODS AND MATERIALS: We conducted a single-institution retrospective study of 20 women (range, 69-88 years) with low-risk EBC treated with a single-fraction APBI (uAPBI) 16 Gy using MIB, between January 2023 and October 2024. All patients had undergone lumpectomy with sentinel lymph node biopsy. Eligibility criteria included age ≥65 years, tumor size ≤3 cm, unifocal disease, sentinel node-negative status and microscopically clear resection margins. Acute and late toxicities, cosmetic outcomes, oncological endpoints and dosimetric parameters were evaluated.
RESULTS: Acute toxicity was limited to Grade 1/2 dermatitis in 25% of patients while no severe late toxicity was observed. Cosmetic outcomes were excellent to good in 100% of patients. At median follow-up of 18 months (range, 10-26), all patients remained alive with no locoregional recurrence or distant metastasis. Dosimetric parameters demonstrated excellent target coverage (median V100%: 97%, range 90-98%).
CONCLUSIONS: Single-fraction MIB-based APBI delivering 16 Gy appears to be a feasible, well-tolerated, and effective treatment approach for carefully selected older patients with EBC. This ultra-hypo fractionated approach significantly reduces treatment burden while maintaining excellent local control and favorable toxicity profiles.
METHODS AND MATERIALS: We conducted a single-institution retrospective study of 20 women (range, 69-88 years) with low-risk EBC treated with a single-fraction APBI (uAPBI) 16 Gy using MIB, between January 2023 and October 2024. All patients had undergone lumpectomy with sentinel lymph node biopsy. Eligibility criteria included age ≥65 years, tumor size ≤3 cm, unifocal disease, sentinel node-negative status and microscopically clear resection margins. Acute and late toxicities, cosmetic outcomes, oncological endpoints and dosimetric parameters were evaluated.
RESULTS: Acute toxicity was limited to Grade 1/2 dermatitis in 25% of patients while no severe late toxicity was observed. Cosmetic outcomes were excellent to good in 100% of patients. At median follow-up of 18 months (range, 10-26), all patients remained alive with no locoregional recurrence or distant metastasis. Dosimetric parameters demonstrated excellent target coverage (median V100%: 97%, range 90-98%).
CONCLUSIONS: Single-fraction MIB-based APBI delivering 16 Gy appears to be a feasible, well-tolerated, and effective treatment approach for carefully selected older patients with EBC. This ultra-hypo fractionated approach significantly reduces treatment burden while maintaining excellent local control and favorable toxicity profiles.