Interstitial Brachytherapy of the Breast and Penis

Interstitial brachytherapy of the breast and penis Summary Aims: Interstitial brachytherapy (BT) is a therapeutic method with a proven history used in treatment of various cancers. In our work we focused on accelerated partial breast irradiation with multicatheter interstitial brachytherapy (MIB APBI) of early breast cancer due to the high incidence of this disease and on BT of early penile cancer as an alternative to primary surgical treatment. Methods and materials: 1) High dose rate brachytherapy (HDR BT) for MIB APBI of early breast cancer has been used at the Department of Oncology and Radiotherapy, University Hospital and Medical Faculty, Hradec Králové since 2012. Brachytherapy catheters are inserted perioperatively in the time of tumorectomy and sentinel node biopsy. APBI starts on day 6 after surgery. The prescribed dose was 34 Gy in 10 fractions applied twice a day. We evaluated 125 patients with minimum follow up of 2 years. 2) Twenty-eight patients with early penile cancer underwent HDR brachytherapy between 2002-2020. The prescribed dose was 18x 3 Gy applied twice a day. Results: 1) One hundred twenty-five patients were indicated for APBI, 12 patients of these did not receive this treatment (9.6 %) due to adverse prognostic factors in the final histology. In these patients the inserted..

Interstitial Brachytherapy of the Breast and Penis

Intersticiální brachyterapie prsu a penisu Souhrn Cíl: Intersticiální brachyterapie (BT) je terapeutickou metodou s ověřenou historií, své využití našla v léčbě různých nádorových onemocnění. V naší práci jsme se zaměřili na intersticiální brachyterapii časného karcinomu prsu metodou akcelerované parciální iradiace pomocí multikatetrové intersticiální brachyterapie (MIB APBI) vzhledem k vysoké incidenci tohoto onemocnění, a na brachyterapii časného karcinomu penisu, jakožto poměrně vzácného nádorového onemocnění, kde BT lze užít jako alternativu k primární chirurgické léčbě. Pacienti a metody: 1) Brachyterapie s vysokým dávkovým příkonem (HDR BT) časného karcinomu prsu metodou MIB APBI se na Klinice onkologie a radioterapie FN a LF Hradec Králové provádí od roku 2012. Brachyterapeutické katetry jsou zaváděny perioperačně v průběhu tumorektomie a exstirpace sentinelové uzliny. APBI se zahajuje 6. den po operaci. Předepsaná dávka je 34 Gy v 10 frakcích aplikovaných 2x denně. Hodnoceno bylo 125 pacientek s minimální dobou sledování 2 roky. 2) Terapii HDR BT podstoupilo v letech 2002-2020 celkem 28 pacientů s časným karcinomem penisu. Předepsaná dávka byla 18 x 3 Gy aplikovaných 2x denně. Výsledky: 1) Ze 125 pacientek indikovaných k APBI tuto léčbu neobdrželo 12 z nich (9.6 %) pro nepříznivé prognostické...Interstitial brachytherapy of the breast and penis Summary Aims: Interstitial brachytherapy (BT) is a therapeutic method with a proven history used in treatment of various cancers. In our work we focused on accelerated partial breast irradiation with multicatheter interstitial brachytherapy (MIB APBI) of early breast cancer due to the high incidence of this disease and on BT of early penile cancer as an alternative to primary surgical treatment. Methods and materials: 1) High dose rate brachytherapy (HDR BT) for MIB APBI of early breast cancer has been used at the Department of Oncology and Radiotherapy, University Hospital and Medical Faculty, Hradec Králové since 2012. Brachytherapy catheters are inserted perioperatively in the time of tumorectomy and sentinel node biopsy. APBI starts on day 6 after surgery. The prescribed dose was 34 Gy in 10 fractions applied twice a day. We evaluated 125 patients with minimum follow up of 2 years. 2) Twenty-eight patients with early penile cancer underwent HDR brachytherapy between 2002-2020. The prescribed dose was 18x 3 Gy applied twice a day. Results: 1) One hundred twenty-five patients were indicated for APBI, 12 patients of these did not receive this treatment (9.6 %) due to adverse prognostic factors in the final histology. In these patients the inserted...Department of Oncology and RadiotherapyKlinika onkologie a radioterapieFaculty of Medicine in Hradec KrálovéLékařská fakulta v Hradci Králov

Special Techniques of Adjuvant Breast Carcinoma Radiotherapy

Modern radiotherapy techniques are designed to permit reduced irradiation of healthy tissue, resulting in a diminished risk of adverse effects and shortened recovery times. Several randomized studies have demonstrated the benefits of increased dosage to the tumor bed area in combination with whole breast irradiation (WBI). Conventional WBI treatment following breast-conserving procedures, which required 5–7 weeks of daily treatments, has been reduced to 3–4 weeks when using hyperfractionated regimens. The dosage administration improves local control, albeit with poorer cosmesis. The method of accelerated partial breast irradiation (APBI) shortens the treatment period whilst reducing the irradiated volume. APBI can be delivered using intraoperative radiation, brachytherapy, or external beam radiotherapy. Currently available data support the use of external beam partial breast irradiation in selected patients. Modern radiotherapy techniques make it possible to achieve favorable cosmesis in most patients undergoing immediate breast reconstruction surgery, and studies confirm that current methods of external beam radiation allow an acceptable coverage of target volumes both in the reconstructed breast and in the regional lymphatic nodes

Special Techniques of Adjuvant Breast Carcinoma Radiotherapy

Modern radiotherapy techniques are designed to permit reduced irradiation of healthy tissue, resulting in a diminished risk of adverse effects and shortened recovery times. Several randomized studies have demonstrated the benefits of increased dosage to the tumor bed area in combination with whole breast irradiation (WBI). Conventional WBI treatment following breast-conserving procedures, which required 5–7 weeks of daily treatments, has been reduced to 3–4 weeks when using hyperfractionated regimens. The dosage administration improves local control, albeit with poorer cosmesis. The method of accelerated partial breast irradiation (APBI) shortens the treatment period whilst reducing the irradiated volume. APBI can be delivered using intraoperative radiation, brachytherapy, or external beam radiotherapy. Currently available data support the use of external beam partial breast irradiation in selected patients. Modern radiotherapy techniques make it possible to achieve favorable cosmesis in most patients undergoing immediate breast reconstruction surgery, and studies confirm that current methods of external beam radiation allow an acceptable coverage of target volumes both in the reconstructed breast and in the regional lymphatic nodes

High-Dose-Rate Brachytherapy as an Organ-Sparing Treatment for Early Penile Cancer

Background: Low-dose-rate brachytherapy is an effective organ-sparing treatment for patients with early-stage penile cancer. However, only limited data are available on the role of high-dose-rate brachytherapy (HDR-BT) in this clinical setting. Methods: Between 2002 and 2020, 31 patients with early penile cancer were treated at our center with interstitial HDR BT at a dose of 18 × 3 Gy twice daily. A breast brachytherapy template was used for the fixation of stainless hollow needles. Results: The median follow-up was 117.5 months (range, 5–210). Eight patients (25.8%) developed a recurrence; of these, seven were salvaged by partial amputation. Six patients died of internal comorbidities or a second cancer. The probability of local control at 5 and 10 years was 80.7% (95% CI: 63.7–97.7%) and 68.3% (95% CI: 44.0–92.6%), respectively. Cause-specific survival was 100%. Only one case of radiation-induced necrosis was observed. The probability of penile sparing at 5 and 10 years was 80.6% (95% CI: 63.45–97.7%) and 62.1% (95% CI: 34.8–89.4%), respectively. Conclusions: These results show that HDR-BT for penile cancer can achieve results comparable to LDR-BT with organ sparing. Despite the relatively large patient cohort—the second largest reported to date in this clinical setting—prospective data from larger samples are needed to confirm the role of HDR-BT in penile cancer