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Accelerated partial breast irradiation with interstitial implants: risk factors associated with increased local
Oliver J Ott1, Guido Hildebrandt, Richard Pötter
1University Hospital Erlangen, Department of Radiation Oncology, Erlangen, Germany. oliver.ott@uk-erlangen.de
Summary
Accelerated partial breast irradiation (APBI) shows excellent 5-year local control. Younger patients (<50) may need exclusion, while hormone-sensitive breast cancer patients benefit from adjuvant antihormonal treatment (AHT).
Area of Science:
- Oncology
- Radiation Oncology
- Breast Cancer Research
Background:
- Interstitial multicatheter accelerated partial breast irradiation (APBI) is a treatment option for early breast cancer.
- Assessing factors influencing local control is crucial for optimizing APBI outcomes.
Purpose of the Study:
- To analyze patient, disease, and treatment-related factors impacting local control after interstitial multicatheter APBI.
- To identify patient subgroups who may benefit most or least from APBI.
Main Methods:
- A prospective Phase II trial (NCT00392184) involving 274 early breast cancer patients.
- Comparison of pulsed-dose-rate (PDR) and high-dose-rate (HDR) brachytherapy techniques.
- Analysis of patient age, histology, and use of antihormonal treatment (AHT) in relation to local recurrence-free survival (LRFS).
Main Results:
- Excellent 5-year local recurrence-free survival (LRFS) rate of 97.7% was observed.
- Patients aged <50 years had significantly lower 5-year LRFS (92.5%) compared to those ≥50 years (98.9%; p=0.030).
- Patients receiving AHT demonstrated significantly better 5-year LRFS (99%) compared to those not receiving AHT (84.9%; p=0.0087).
- Lobular histology did not negatively impact local control.
Conclusions:
- Interstitial multicatheter APBI achieves excellent local control, comparable to whole-breast irradiation.
- Age <50 years may be a criterion for excluding patients from APBI protocols.
- Adjuvant AHT is strongly recommended for hormone-sensitive breast cancer patients undergoing APBI.
- Lobular histology should not be an exclusion criterion for future APBI studies.
