Partial breast irradiation with interstitial high dose-rate brachytherapy in elderly patients: results of a phase II prospective study

Materials and methods Between August 2003 and July 2008, 50 women (median age 65 years; range 65–84; 45 with infiltrating ductal, 1 infiltrating tubular, 1 infiltrating papillary and 3 DCIS) were enrolled in a phase II prospective study. Treatment schedule was 4 Gy twice a day for a total dose of 32 Gy, with a minimum interval of 6 hours between the two daily fraction Therapy was delivered using a microSelectron HDR 192Ir remote afterloading system (Nucletron, The Netherlands). Catheter implantation was performed during surgery or re-excision (in patients with positive or "close" margins) in 7 cases and postoperatively, at a median of 8 weeks (range 4–12) after surgery, in 43 patients. Two patients received adjuvant chemotherapy: CMF for 6 cycles in 1, and epirubicine for 14 weekly administrations in the other one. Adjuvant hormone therapy was prescribed for 39 patients (tamoxifen in 25 and anastrozole in 14). Results At a median follow-up of 32 months (range 5–63), acute G1 skin toxicity occurred in 2 cases; late subcutaneous toxicity in 3 (2 G1 and 1 G2); teleangiectasia occurred in 7 patients while fat necrosis occurred in 3 cases. Cosmetic results (evaluated by radiation oncologists and patients) were good to excellent in all cases.