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Abstract
Introduction. Publications in the Russian literature on the use of intrathecal high-dose rate brachytherapy (HDRB) with a high-dose-rate Ir192 source (HDRI) for accelerated partial-breast irradiation (APBI) in breast cancer (BC) patients are extremely rare. In fact, there is no experience of using HDRI for this purpose.
Aim. To conduct a comparative analysis of the five-year efficiency indicators including five-year recurrence-free survival (RFS) and local control rates, as well as the safety including cosmetic results according to self-assessment, of APBI compared to standard whole breast irradiation (WBI).
Material and Methods. From 2016 to 2020, 185 patients underwent breast-conserving surgery and postoperative radiotherapy (RT) for early BC (pT1-2N0M0) at the N.N. Petrov NMRC of Oncology. Of these patients, 64 underwent APBI, while 121 underwent WBI followed by an additional boost to the tumor bed. A follow-up telephone survey assessing satisfaction with post-RT cosmetic outcomes was conducted with the 185 patients; 127 patients completed the BREAST-Q v2.0 questionnaire.
Results. The median follow-up for the group that received APBI with HDR brachytherapy was 79 months [71, 83]. For the group of 121 patients who underwent WBI followed by additional irradiation of the tumor bed, the median follow-up was 58 months [48, 76]. Five-year local control rates in the ipsilateral breast were 98 % in the APBI group and 98.3 % in the WBI group (p = 0.95). The five-year RFS rates in the two groups were as follows: 93.8 % after APBI and 95.9% after WBI (p = 0.52). The cosmetic result after APBI was rated as 'excellent' by all 53 patients evaluated (100 %). Among those who underwent WBI, the cosmetic result was rated as 'excellent' by 63 out of 74 (85.2 %) surveyed patients (p = 0.003).
Conclusion. Local control in early BC patients treated with APBI using HDRB is comparable to that after WBI, with higher satisfaction with cosmetic results.
References
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