International Journal of Radiation Oncology * Biology * Physics
Volume 53, Issue 4 , Pages 889-897 , 15 July 2002

Preliminary results of a phase I/II study of HDR brachytherapy alone for T1/T2 breast cancer

Presented at the 43rd Annual Meeting of the American Society for Therapeutic Radiology and Oncology, San Francisco, CA, November 4–8, 2001.

  • David E. Wazer, M.D.

      Affiliations

    • Corresponding Author InformationReprint requests to: David E. Wazer, M.D., Department of Radiation Oncology, Tufts-New England Medical Center, No. 359, 750 Washington St., Boston, MA 02111 USA. Tel: 617-636-7673; Fax: 617-636-4513
    • Department of Radiation Oncology, New England Medical Center, Tufts University School of Medicine, Boston, MA USA
    • Department of Radiation Oncology, Rhode Island Hospital, Brown University School of Medicine, Providence, RI, USA
    • Breast Health Center, Women and Infants’ Hospital, Providence, RI USA
  • ,
  • Lisa Berle, D.O.

      Affiliations

    • Department of Radiation Oncology, New England Medical Center, Tufts University School of Medicine, Boston, MA USA
  • ,
  • Roger Graham, M.D.

      Affiliations

    • Department of Surgery, New England Medical Center, Tufts University School of Medicine, Boston, MA, USA
  • ,
  • Maureen Chung, M.D.

      Affiliations

    • Breast Health Center, Women and Infants’ Hospital, Providence, RI USA
  • ,
  • Janice Rothschild, M.D.

      Affiliations

    • Department of Surgery, New England Medical Center, Tufts University School of Medicine, Boston, MA, USA
  • ,
  • Theresa Graves, M.D.

      Affiliations

    • Department of Surgery, Rhode Island Hospital, Brown University School of Medicine, Providence, RI, USA
  • ,
  • Blake Cady, M.D.

      Affiliations

    • Breast Health Center, Women and Infants’ Hospital, Providence, RI USA
  • ,
  • Kenneth Ulin, Ph.D.

      Affiliations

    • Department of Radiation Oncology, New England Medical Center, Tufts University School of Medicine, Boston, MA USA
  • ,
  • Robin Ruthazer, M.P.H.

      Affiliations

    • Division of Clinical Care Research, New England Medical Center, Tufts University School of Medicine, Boston, MA USA
  • ,
  • Thomas A. DiPetrillo, M.D.

      Affiliations

    • Department of Radiation Oncology, New England Medical Center, Tufts University School of Medicine, Boston, MA USA
    • Department of Radiation Oncology, Rhode Island Hospital, Brown University School of Medicine, Providence, RI, USA
    • Breast Health Center, Women and Infants’ Hospital, Providence, RI USA

Received 15 October 2001 ,Revised 14 March 2002 ,Accepted 20 March 2002.

References 

  1. Holland R, Veling SHJ, Mravunac M, et al.  Histologic multifocality of Tis, T1–2 breast carcinomas. Cancer. 1985;56:979–990
  2. Rosen PP, Frachia AA, Urban JA, et al.  Residual mammary carcinoma following simulated partial mastectomy. Cancer. 1975;35:739–744
  3. Faverly DRG, Hendriks JHCL, Holland R. Breast carcinomas of limited extent (Frequency, radiologic-pathologic characteristics, and surgical margin requirements). Cancer. 2001;91:647–659
  4. Fisher ER, Sass R, Fisher B, et al.  Pathologic findings from the National Surgical Adjuvant Breast Project (protocol 6) (Relationship of local recurrence to multicentricity). Cancer. 1986;57:1717–1724
  5. Fisher ER, Anderson S, Redmond C, et al.  Ipsilateral breast tumor recurrence and survival following lumpectomy and irradiation (Pathologic findings from NSABP protocol B-06). Semin Surg Oncol. 1992;8:161–166
  6. Gage I, Recht A, Gelman R, et al.  Long-term outcome following breast conserving surgery, and radiation therapy. Int J Radiat Oncol Biol Phys. 1995;33:245–251
  7. Wazer DE, Schmidt-Ullrich RK, Schmid C, et al.  Factors determining outcome for breast-conserving irradiation with margin directed dose escalation to the tumor bed. Int J Radiat Oncol Biol Phys. 1998;40:851–858
  8. Vicini FA, Chen PY, Fraile M, et al.  Low-dose-rate brachytherapy as the sole radiation modality in the management of patients with early-stage breast cancer treated with breast-conserving therapy (Preliminary results of a pilot trial). Int J Radiat Oncol Biol Phys. 1997;38:301–310
  9. Kuske RR, Bolton JS, McKinnon WMP, et al.  5-year results of a prospective phase II trial of wide-volume brachytherapy as the sole method of breast irradiation in Tis, T1, T2, N0–1 breast cancer. [Abstract] Int J Radiat Oncol Biol Phys. 1998;42(Suppl. 1):181
  10. Schnitt S, Connolly J, Harris JR, et al.  Pathologic predictors of early local recurrence in Stage I and II breast cancer treated by primary radiation therapy. Cancer. 1984;53:1049–1057
  11. Zwicker RD, Schmidt-Ullrich RK. Dose uniformity in a planar interstitial implant system. Int J Radiat Oncol Biol Phys. 1995;31:149–155
  12. Kuske R, Bolton JS. A phase I/II trial to evaluate brachytherapy as the sole method of radiation therapy for stage I and II breast carcinoma. Radiation Therapy Oncology Group Publication No. 1055. Philadelphia: Radiation Therapy Oncology Group; 1995;
  13. Anderson LL. A “natural” volume-dose histogram for brachytherapy. Med Phys. 1986;13:898–903
  14. Wazer DE, DiPetrillo TA, Schmidt-Ullrich RK, et al.  Factors influencing cosmetic outcome and complication risk after conservative surgery and radiotherapy for early stage breast carcinoma. J Clin Oncol. 1992;10:356–363
  15. Clarke DH, Vicini FA, Jacobs H, et al.  High dose rate brachytherapy for breast cancer. In:  Nag S editors. High dose rate brachytherapy (A textbook). Arnonk, New York: Futura Publishing; 1994;p. 321–329
  16. Fentimen IS, Poole C, Tong D, et al.  Iridium implant treatment without external radiotherapy for operable breast cancer (A pilot study). Eur J Cancer. 1991;27:447–450
  17. Perera F, Engel J, Holliday R, et al.  Local resection and brachytherapy confined to the lumpectomy site for early breast cancer (A pilot study). J Surg Oncol. 1997;65:263–267
  18. Martinez AA, Chen PY, Gustafson G, et al.  Irradiation of the tumor bed alone after lumpectomy with high dose rate brachytherapy. Proceedings of the 19th Annual Meeting of the American Brachytherapy Society. 1997;
  19. King TA, Bolton JS, Kuske RR, et al.  Long-term results of wide-field brachytherapy as the sole method of radiation therapy after segmental mastectomy for Tis,1,2 breast cancer. Am J Surg. 2000;180:299–304
  20. Vicini FA, Baglan KL, Kestin LL, et al.  Accelerated treatment of breast cancer. J Clin Oncol. 2001;19:1993–2001
  21. Vicini FA, Jaffray DA, Horwitz EM, et al.  Implementation of 3D-virtual brachytherapy in the management of breast cancer (A description of a new method of interstitial brachytherapy). Int J Radiat Oncol Biol Phys. 1998;40:629–635
  22. Vicini FA, Kini VR, Chen P, et al.  Irradiation of the tumor bed alone after lumpectomy in selected patients with early-stage breast cancer treated with breast conserving therapy. J Surg Oncol. 1999;70:33–40
  23. Vicini FA, Kestin LL, Edmundson GK, et al.  Dose-volume analysis for quality assurance of interstitial brachytherapy for breast cancer. Int J Radiat Oncol Biol Phys. 1999;45:803–810
  24. Baglan KL, Martinez AA, Frazier RC, et al.  The use of high-dose-rate brachytherapy alone after lumpectomy in patients with early-stage breast cancer treated with breast-conserving therapy. Int J Radiat Oncol Biol Phys. 2001;50:1003–1011
  25. Wazer DE, Lowther D, Boyle T, et al.  Clinically evident fat necrosis in women treated with high-dose-rate brachytherapy alone for early-stage breast cancer. Int J Radiat Oncol Biol Phys. 2001;50:107–111

PII: S0360-3016(02)02824-9

International Journal of Radiation Oncology * Biology * Physics
Volume 53, Issue 4 , Pages 889-897 , 15 July 2002