Accelerated partial breast irradiation with interstitial brachytherapy as second conservative treatment for ipsilateral breast tumour recurrence

Multicentric study of the GEC-ESTRO Breast Cancer Working Group

Jean Michel Hannoun-Levi, Alexandra Resch, Jocelyn Gal, Daniela Kauer-Dorner, Vratislav Strnad, Peter Niehoff, Kristina Loessl, Gyoergy Kovács, Erick Van Limbergen, C. Polgár

Research output: Contribution to journalArticle

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Abstract

Purpose To analyse the clinical outcome after salvage lumpectomy and multi-catheter brachytherapy (MCB) for ipsilateral breast tumour recurrence (IBTR). Material and methods Between 09/00 and 09/10, 217 patients presenting an IBTR underwent lumpectomy and MCB (low, pulsed, or high-dose rate). Survival rates without second local recurrence (2nd LR), distant metastasis (DM), and overall survival (OS) were analysed as well as late effects and cosmetic results. Univariate and multivariate analyses (MVA) based on IBTR data were performed to find prognostic factors for 2nd LR, DM, and OS. Results Median follow-up after the IBTR was 3.9 years [range: 1.1-10.3]. Five and 10-year actuarial 2nd LR rates were 5.6% [range: 1.5-9.5] and 7.2% [range: 2.1-12.1], respectively. Five and 10-year actuarial DM rates were 9.6% [range: 5.7-15.2] and 19.1% [range: 7.8-28.3], respectively. Five and 10-year actuarial OS rates were 88.7% [range: 83.1-94.8] and 76.4% [range: 66.9-87.3], respectively. In MVA, histological grade was prognostic factor for 2nd LR (p = 0.008) and OS (p = 0.02); while tumour size was prognostic factor for DM (p = 0.03). G3-4 complication rate was 11%. Excellent/good cosmetic result was achieved in 85%. Conclusion This study suggests that in case of IBTR, lumpectomy plus MCB is feasible and effective in preventing 2nd LR with an OS rate at least equivalent to those achieved with salvage mastectomy.

Original languageEnglish
Pages (from-to)226-231
Number of pages6
JournalRadiotherapy and Oncology
Volume108
Issue number2
DOIs
Publication statusPublished - Aug 2013

Fingerprint

Brachytherapy
Breast
Breast Neoplasms
Recurrence
Segmental Mastectomy
Neoplasm Metastasis
Catheters
Survival Rate
Cosmetics
Survival
Multivariate Analysis
Mastectomy
Conservative Treatment
Neoplasms

Keywords

  • Brachytherapy
  • Breast cancer
  • Conservative treatment
  • Local recurrence

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology

Cite this

Accelerated partial breast irradiation with interstitial brachytherapy as second conservative treatment for ipsilateral breast tumour recurrence : Multicentric study of the GEC-ESTRO Breast Cancer Working Group. / Hannoun-Levi, Jean Michel; Resch, Alexandra; Gal, Jocelyn; Kauer-Dorner, Daniela; Strnad, Vratislav; Niehoff, Peter; Loessl, Kristina; Kovács, Gyoergy; Van Limbergen, Erick; Polgár, C.

In: Radiotherapy and Oncology, Vol. 108, No. 2, 08.2013, p. 226-231.

Research output: Contribution to journalArticle

Hannoun-Levi, Jean Michel ; Resch, Alexandra ; Gal, Jocelyn ; Kauer-Dorner, Daniela ; Strnad, Vratislav ; Niehoff, Peter ; Loessl, Kristina ; Kovács, Gyoergy ; Van Limbergen, Erick ; Polgár, C. / Accelerated partial breast irradiation with interstitial brachytherapy as second conservative treatment for ipsilateral breast tumour recurrence : Multicentric study of the GEC-ESTRO Breast Cancer Working Group. In: Radiotherapy and Oncology. 2013 ; Vol. 108, No. 2. pp. 226-231.
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abstract = "Purpose To analyse the clinical outcome after salvage lumpectomy and multi-catheter brachytherapy (MCB) for ipsilateral breast tumour recurrence (IBTR). Material and methods Between 09/00 and 09/10, 217 patients presenting an IBTR underwent lumpectomy and MCB (low, pulsed, or high-dose rate). Survival rates without second local recurrence (2nd LR), distant metastasis (DM), and overall survival (OS) were analysed as well as late effects and cosmetic results. Univariate and multivariate analyses (MVA) based on IBTR data were performed to find prognostic factors for 2nd LR, DM, and OS. Results Median follow-up after the IBTR was 3.9 years [range: 1.1-10.3]. Five and 10-year actuarial 2nd LR rates were 5.6{\%} [range: 1.5-9.5] and 7.2{\%} [range: 2.1-12.1], respectively. Five and 10-year actuarial DM rates were 9.6{\%} [range: 5.7-15.2] and 19.1{\%} [range: 7.8-28.3], respectively. Five and 10-year actuarial OS rates were 88.7{\%} [range: 83.1-94.8] and 76.4{\%} [range: 66.9-87.3], respectively. In MVA, histological grade was prognostic factor for 2nd LR (p = 0.008) and OS (p = 0.02); while tumour size was prognostic factor for DM (p = 0.03). G3-4 complication rate was 11{\%}. Excellent/good cosmetic result was achieved in 85{\%}. Conclusion This study suggests that in case of IBTR, lumpectomy plus MCB is feasible and effective in preventing 2nd LR with an OS rate at least equivalent to those achieved with salvage mastectomy.",
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T1 - Accelerated partial breast irradiation with interstitial brachytherapy as second conservative treatment for ipsilateral breast tumour recurrence

T2 - Multicentric study of the GEC-ESTRO Breast Cancer Working Group

AU - Hannoun-Levi, Jean Michel

AU - Resch, Alexandra

AU - Gal, Jocelyn

AU - Kauer-Dorner, Daniela

AU - Strnad, Vratislav

AU - Niehoff, Peter

AU - Loessl, Kristina

AU - Kovács, Gyoergy

AU - Van Limbergen, Erick

AU - Polgár, C.

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N2 - Purpose To analyse the clinical outcome after salvage lumpectomy and multi-catheter brachytherapy (MCB) for ipsilateral breast tumour recurrence (IBTR). Material and methods Between 09/00 and 09/10, 217 patients presenting an IBTR underwent lumpectomy and MCB (low, pulsed, or high-dose rate). Survival rates without second local recurrence (2nd LR), distant metastasis (DM), and overall survival (OS) were analysed as well as late effects and cosmetic results. Univariate and multivariate analyses (MVA) based on IBTR data were performed to find prognostic factors for 2nd LR, DM, and OS. Results Median follow-up after the IBTR was 3.9 years [range: 1.1-10.3]. Five and 10-year actuarial 2nd LR rates were 5.6% [range: 1.5-9.5] and 7.2% [range: 2.1-12.1], respectively. Five and 10-year actuarial DM rates were 9.6% [range: 5.7-15.2] and 19.1% [range: 7.8-28.3], respectively. Five and 10-year actuarial OS rates were 88.7% [range: 83.1-94.8] and 76.4% [range: 66.9-87.3], respectively. In MVA, histological grade was prognostic factor for 2nd LR (p = 0.008) and OS (p = 0.02); while tumour size was prognostic factor for DM (p = 0.03). G3-4 complication rate was 11%. Excellent/good cosmetic result was achieved in 85%. Conclusion This study suggests that in case of IBTR, lumpectomy plus MCB is feasible and effective in preventing 2nd LR with an OS rate at least equivalent to those achieved with salvage mastectomy.

AB - Purpose To analyse the clinical outcome after salvage lumpectomy and multi-catheter brachytherapy (MCB) for ipsilateral breast tumour recurrence (IBTR). Material and methods Between 09/00 and 09/10, 217 patients presenting an IBTR underwent lumpectomy and MCB (low, pulsed, or high-dose rate). Survival rates without second local recurrence (2nd LR), distant metastasis (DM), and overall survival (OS) were analysed as well as late effects and cosmetic results. Univariate and multivariate analyses (MVA) based on IBTR data were performed to find prognostic factors for 2nd LR, DM, and OS. Results Median follow-up after the IBTR was 3.9 years [range: 1.1-10.3]. Five and 10-year actuarial 2nd LR rates were 5.6% [range: 1.5-9.5] and 7.2% [range: 2.1-12.1], respectively. Five and 10-year actuarial DM rates were 9.6% [range: 5.7-15.2] and 19.1% [range: 7.8-28.3], respectively. Five and 10-year actuarial OS rates were 88.7% [range: 83.1-94.8] and 76.4% [range: 66.9-87.3], respectively. In MVA, histological grade was prognostic factor for 2nd LR (p = 0.008) and OS (p = 0.02); while tumour size was prognostic factor for DM (p = 0.03). G3-4 complication rate was 11%. Excellent/good cosmetic result was achieved in 85%. Conclusion This study suggests that in case of IBTR, lumpectomy plus MCB is feasible and effective in preventing 2nd LR with an OS rate at least equivalent to those achieved with salvage mastectomy.

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