论文部分内容阅读
Background: The efficacy of an accelerated partial breast irradiation (APBI) has been investigated compared with whole-breast irradiation (WPI).APBI starting just after surgery might give more benefit by intra-operative insertion of catheters.Although balloon catheter-based APBI is available in the US, it would not be adapted for Japanese women with small breast.When the applicators are implanted during operation for the tumor, APBI can start just after surgery.The aim of this study is an assessment of the efficacy and safety of APBI using Intra-operative Open-cavity Implant (IOCI) technique.Method: Patients (≥3d40yrs) with invasive breast cancer (-3d3 cm) were enrolled.Before the lumpectomy, the insertion of applicators and delivery doses were simulated with CT.After the confirmation of the free margin and negative SNs for metastasisusing frozen section analysis, applicators were inserted.Dose distribution analysis, using dose-volume histograms, was achieved based on a postoperative CT.APB1 was started the same day of the operation.APBI therapy delivered 32 Gy in 8 fractions over 5-6 days with coverage of 2 cm tumor margins.Results: From October 2008 to June 2011, 124 women (125 le.sions) were enrolled (55.0 y/o, <40∶10, sn+:22, for patients request).The mean number of applicators was 6.7 (2-15).The mean PTV was 37.0cm3 (6.5-137).All toxicities related to radiation therapy were mild.However, 10 patients (8.1%) had wound break due to surgical-site infection.Two patients developed ILBR (1: marginal; 1: elsewhere lesion).Cosmetic outcomes were assessed using Harvard Breast Cosmesis Grading for 95/106 patients (>6 months after surgery), 81 patients (85.2%) could achieve excellent/good cosmetic results.Conclusions: Although this study is a small number of participants and short follow-up period, this convenient technique should be needed to establish clinical efficacy and safety.