Retrospective Analysis of the Clinical Usefulness of a Strut-Adjusted Volume Implant in a Single Center

Overview

Journal Eur J Breast Health

Publisher Galenos Publishing House

Date 2024 Sep 11

PMID 39257014

Authors

Arisa Ata-Shiroshita

Takashi Kuwayama

Masako Kato

Hidenori Shinjo

Kazunori Miyaura

Aya Nagata

Nana Komatsu

Misaki Matsuyanagi

Haruna Sakai

Yuki Matsunaga

Sayuka Nakayama

Ayuha Yoshizawa

Murasaki Ikeda

Kanae Taruno

Hiroko Masuda

Terumasa Sawada

Naoki Hayashi

Yoshinori Ito

Chie Watanabe

Sadako Akashi-Tanaka

Seigo Nakamura

Affiliations

Soon will be listed here.

Abstract

Objective: Reports demonstrating the effectiveness and safety of strut-adjusted volume implants (SAVI) in Japan are limited. Therefore, this study aimed to compare the treatment outcomes of SAVI and whole-breast irradiation (WBI) at a single facility.

Materials And Methods: Data were retrospectively extracted from the medical records of patients treated with SAVI or WBI following partial mastectomy (Bp). Patients undergoing Bp, sentinel lymph node biopsy, and SAVI spacer insertion followed by brachytherapy with the SAVI device were compared to those followed with WBI. Local recurrence was assessed annually by physical examination, bilateral mammography, and breast ultrasonography.

Results: The SAVI and WBI groups comprised 53 and 113 patients, with a median age of 55 and 52 years, respectively; among them, 47 and 91 patients had a pathological tumor diameter ≤2 cm and six and 22 had a pathological tumor diameter >2 cm, respectively. Recurrence events, acute adverse events, and late adverse events were observed in the SAVI and WBI groups in 1 and 3 ( = 0.726), 24 and 79 ( = 0.01), and 24 and 18 patients ( = 0.00002), respectively, with median observation periods of 60.0 and 47.8 months, respectively. All adverse events were grades 1-2, with dermatitis being the most common in the acute phase. In the late phase, pigmentation was common in both groups.

Conclusion: The local recurrence rate does not differ between SAVI and WBI within the relatively short-term follow-up period. Longer follow-up is required to confirm our results in the Japanese population.

References

Fisher E, Anderson S, Tan-Chiu E, Fisher B, Eaton L, Wolmark N . Fifteen-year prognostic discriminants for invasive breast carcinoma: National Surgical Adjuvant Breast and Bowel Project Protocol-06. Cancer. 2001; 91(8 Suppl):1679-87. View

Orecchia R, Veronesi U, Maisonneuve P, Galimberti V, Lazzari R, Veronesi P . Intraoperative irradiation for early breast cancer (ELIOT): long-term recurrence and survival outcomes from a single-centre, randomised, phase 3 equivalence trial. Lancet Oncol. 2021; 22(5):597-608. DOI: 10.1016/S1470-2045(21)00080-2. View

Darby S, McGale P, Correa C, Taylor C, Arriagada R, Clarke M . Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011; 378(9804):1707-16. PMC: 3254252. DOI: 10.1016/S0140-6736(11)61629-2. View

Strnad V, Ott O, Hildebrandt G, Kauer-Dorner D, Knauerhase H, Major T . 5-year results of accelerated partial breast irradiation using sole interstitial multicatheter brachytherapy versus whole-breast irradiation with boost after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast:.... Lancet. 2015; 387(10015):229-38. DOI: 10.1016/S0140-6736(15)00471-7. View

Yoshida M, Yoshimura R, Notake R, Shinjo H, Miyaura K, Kuwayama T . 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. Breast Cancer. 2023; 31(1):75-83. DOI: 10.1007/s12282-023-01513-x. View

Meattini I, Becherini C, Boersma L, Kaidar-Person O, Marta G, Montero A . European Society for Radiotherapy and Oncology Advisory Committee in Radiation Oncology Practice consensus recommendations on patient selection and dose and fractionation for external beam radiotherapy in early breast cancer. Lancet Oncol. 2022; 23(1):e21-e31. DOI: 10.1016/S1470-2045(21)00539-8. View

Whelan T, Julian J, Berrang T, Kim D, Germain I, Nichol A . External beam accelerated partial breast irradiation versus whole breast irradiation after breast conserving surgery in women with ductal carcinoma in situ and node-negative breast cancer (RAPID): a randomised controlled trial. Lancet. 2019; 394(10215):2165-2172. DOI: 10.1016/S0140-6736(19)32515-2. View

Yashar C, Attai D, Butler E, Einck J, Finkelstein S, Han B . Strut-based accelerated partial breast irradiation: Report of treatment results for 250 consecutive patients at 5 years from a multicenter retrospective study. Brachytherapy. 2016; 15(6):780-787. DOI: 10.1016/j.brachy.2016.07.002. View

Meattini I, Marrazzo L, Saieva C, Desideri I, Scotti V, Simontacchi G . Accelerated Partial-Breast Irradiation Compared With Whole-Breast Irradiation for Early Breast Cancer: Long-Term Results of the Randomized Phase III APBI-IMRT-Florence Trial. J Clin Oncol. 2020; 38(35):4175-4183. DOI: 10.1200/JCO.20.00650. View

10.

Shaitelman S, Anderson B, Arthur D, Bazan J, R Bellon J, Bradfield L . Partial Breast Irradiation for Patients With Early-Stage Invasive Breast Cancer or Ductal Carcinoma In Situ: An ASTRO Clinical Practice Guideline. Pract Radiat Oncol. 2023; 14(2):112-132. DOI: 10.1016/j.prro.2023.11.001. View

11.

Sato K, Fuchikami H, Takeda N, Shimo T, Kato M, Okawa T . Efficacy of Single-Plane Implant Technique in Partial Breast Brachytherapy in Small-Breasted Patients. Int J Radiat Oncol Biol Phys. 2019; 106(4):830-837. DOI: 10.1016/j.ijrobp.2019.11.024. View

12.

Veronesi U, Marubini E, Mariani L, Galimberti V, Luini A, Veronesi P . Radiotherapy after breast-conserving surgery in small breast carcinoma: long-term results of a randomized trial. Ann Oncol. 2001; 12(7):997-1003. DOI: 10.1023/a:1011136326943. View

13.

Coles C, Griffin C, Kirby A, Titley J, Agrawal R, Alhasso A . Partial-breast radiotherapy after breast conservation surgery for patients with early breast cancer (UK IMPORT LOW trial): 5-year results from a multicentre, randomised, controlled, phase 3, non-inferiority trial. Lancet. 2017; 390(10099):1048-1060. PMC: 5594247. DOI: 10.1016/S0140-6736(17)31145-5. View

14.

Brunt A, Haviland J, Wheatley D, Sydenham M, Alhasso A, Bloomfield D . Hypofractionated breast radiotherapy for 1 week versus 3 weeks (FAST-Forward): 5-year efficacy and late normal tissue effects results from a multicentre, non-inferiority, randomised, phase 3 trial. Lancet. 2020; 395(10237):1613-1626. PMC: 7262592. DOI: 10.1016/S0140-6736(20)30932-6. View

15.

Benitez P, Chen P, Vicini F, Wallace M, Kestin L, Edmundson G . Partial breast irradiation in breast conserving therapy by way of intersitial brachytherapy. Am J Surg. 2004; 188(4):355-64. DOI: 10.1016/j.amjsurg.2004.06.027. View

16.

Shah C, Badiyan S, Wilkinson J, Vicini F, Beitsch P, Keisch M . Treatment efficacy with accelerated partial breast irradiation (APBI): final analysis of the American Society of Breast Surgeons MammoSite(®) breast brachytherapy registry trial. Ann Surg Oncol. 2013; 20(10):3279-85. DOI: 10.1245/s10434-013-3158-4. View

17.

Vicini F, Cecchini R, White J, Arthur D, Julian T, Rabinovitch R . Long-term primary results of accelerated partial breast irradiation after breast-conserving surgery for early-stage breast cancer: a randomised, phase 3, equivalence trial. Lancet. 2019; 394(10215):2155-2164. PMC: 7199428. DOI: 10.1016/S0140-6736(19)32514-0. View