American Brachytherapy Society Task Group Report: Long-term control and toxicity with brachytherapy for localized breast cancer

作者：Shaitelman Simona F^*; Amendola Beatriz; Khan Atif; Beriwal Sushil; Rabinovitch Rachel; Demanes D Jeffrey; Kim Leonard H; Cuttino Laurie

来源：Brachytherapy, 2017, 16(1): 13-21.

DOI：10.1016/j.brachy.2016.04.392

• Breast cancer
• Brachytherapy
• Interstitial catheter
• Toxicity

PURPOSE: There has been significant controversy regarding the equivalency of accelerated partial breast irradiation to whole-breast irradiation. With the recent publication of a large, randomized trial comparing these two treatment modalities, an update on the current state of knowledge of brachytherapy-based accelerated partial breast irradiation, with respect to local control and toxicities, would be useful to practitioners and patients.
METHODS AND MATERIALS: A systematic literature review was conducted examining articles published between January 2000 and April 2016 on the topics "brachytherapy" and "breast." A total of 67 articles met inclusion criteria, providing outcomes on local tumor control and/or toxicity for breast brachytherapy.
RESULTS: Reported 5-year local failure rates were 1.4-6.1% for multicatheter interstitial brachytherapy (MB) and 0-5.7% for single-entry brachytherapy catheters when delivered to patients with standard selection criteria. Toxicity profiles are acceptable, with cosmetic outcomes comparable to whole-breast irradiation. The reported rates of infection were 0-12%. Symptomatic fat necrosis was found in 0-12% and 0-3.2% of patients treated with MIB and single-entry brachytherapy catheters, respectively. Late Grade telangiectasias and fibrosis were reported in 0-8% and 0-9.1% of patients treated with MIB, respectively. These side effects were less common with single-entry brachytherapy catheters (0-2.0% and 0%, respectively).
CONCLUSIONS: Breast brachytherapy is a treatment technique that provides acceptable rates of local control in select patients, as demonstrated by Level I evidence. The side effect profile of this treatment is well documented and should be shared with patients when considering this treatment modality.

• 出版日期2017-2