Feasibility of accelerated partial breast irradiation with strut-adjusted volume implant brachytherapy in Japan focusing on dosimetry and acute toxicity: a Japanese multi-institutional prospective study.

Autor: Yoshida M; Department of Radiation Therapeutics and Oncology, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan.; Department of Radiology, Toho University Ohashi Medical Center, 2-22-36 Ohashi, Meguro-ku, Tokyo, Japan., Yoshimura RI; Department of Radiation Therapeutics and Oncology, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan. ysmrmrad@tmd.ac.jp., Notake R; Radiology Center, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan., Shinjo H; Division of Radiation Oncology, Department of Radiology, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo, Japan., Miyaura K; Division of Radiation Oncology, Department of Radiology, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo, Japan., Kuwayama T; Division of Breast Surgical Oncology, Department of Surgery, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo, Japan., Kawanaka T; Department of Radiology and Radiation Oncology, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, Japan., Shien T; Department of Breast and Endocrine Surgery, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama, Japan., Yoshio K; Department of Proton Beam Therapy, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama City, Okayama, Japan., Shiga T; Department of Radiology, Kansai Medical University Medical Center, 10-15 Fumizono-cho, Moriguchi, Osaka, Japan., Kaneyasu Y; Department of Radiation Oncology, National Hospital Organization Fukuyama Medical Center, 4-14-17 Okinogami-cho, Fukuyama, Hiroshima, Japan., Nakagawa T; Department of Breast Surgery, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan., Kubota K; Department of Radiology, Dokkyo Medical University Saitama Medical Center, Minamikoshigaya 2-1-50, Koshigaya, Saitama, Japan., Nakamura S; Division of Breast Surgical Oncology, Department of Surgery, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo, Japan., Itami J; ShinMatsudo Accuracy Radiation Therapy Center, ShinMatsudo Central General Hospital, Matsudo 1-380, Matsudo City, Chiba, Japan.
Jazyk: angličtina
Zdroj: Breast cancer (Tokyo, Japan) [Breast Cancer] 2024 Jan; Vol. 31 (1), pp. 75-83. Date of Electronic Publication: 2023 Oct 21.
DOI: 10.1007/s12282-023-01513-x
Abstrakt: Background: A Japanese multi-institutional prospective study was initiated to investigate the effectiveness and safety of accelerated partial breast irradiation (APBI) using strut-adjusted volume implant (SAVI) brachytherapy, with subjects registered between 2016 and 2021. Herein, we report the preliminary results on the feasibility of this treatment modality in Japan, focusing on the registration process, dosimetry, and acute toxicities.
Patients and Methods: Primary registration was conducted before breast-conserving surgery (BCS) and the eligibility criteria included the following: age ≥ 40 years, tumor unifocal and unicentric, ≤ 3 cm in diameter, cN0M0, proven ductal, mucinous, tubular, medullary, or lobular carcinoma by needle biopsy. Secondary registration was conducted after BCS had been performed leaving a cavity for device implantation and pathological evaluations, and the eligibility criteria were as follows: negative surgical margin, tumor ≤ 3 cm in diameter on gross pathological examination, histologically confirmed ductal, mucinous, tubular medullary, colloid, or lobular carcinoma, pN0, L0V0, no extensive ductal component, no initiation of chemotherapy within 2 weeks of the brachytherapy APBI planning with SAVI was performed for the patients successfully entered in the study by the secondary registration process, and the treatment was administered at the dose of 34 Gy in 10 fractions administered twice daily.
Results: Between 2016 and 2021, 64 women were enrolled in the study through primary registration, of which 19 were excluded from the secondary registration process, and in one, it was deemed impossible to comply with the dose constraints established during treatment planning. After the exclusion of these latter 20 patients, we treated the remaining 44 patients by APBI with SAVI. The dose constraints could be adhered to in all the patients, but re-planning was necessitated in 3 patients because of applicator movement during the treatment period. Grade 2 acute toxicities were observed in 18% of all patients, but more severe acute toxicities than Grade 2 were not observed in any of the patients.
Conclusion: APBI with SAVI brachytherapy is feasible in Japan from the aspects of compliance with dose constraints and frequency of acute toxicities.
(© 2023. The Author(s), under exclusive licence to The Japanese Breast Cancer Society.)
Databáze: MEDLINE
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