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Posted by on May 28, 2023 in Breast cancer | 0 comments

In a nutshell

The study evaluated the long-term effectiveness of accelerated partial breast irradiation (ABPI) using multicatheter brachytherapy (BT) with whole-breast irradiation (WBI) in patients with early breast cancer (BC). The study found that ABPI using multicatheter BT was similarly effective with fewer serious side effects compared to WBI in patients with early BC after breast-conserving surgery (BCS).

Some background

Patients with early BC are often treated with breast-conserving surgery (BCS) followed by radiotherapy (RT). This involves removing the cancer only and RT of the entire breast (WBI) of the remaining breast to reduce the risk of cancer coming back. However, WBI involves long periods of time and large doses of radiation. It can also have significant side effects such as skin modifications that can impact a woman's quality of life.  

Accelerated partial breast irradiation (ABPI) is an alternative to WBI. ABPI uses radiation to destroy cancer cells in small areas of the breast. It shortens treatment time and reduces exposure to radiation. A multicatheter BT involves small tubes or catheters stitched beneath the skin. Once the tubes are in place, a radioactive seed is placed into the catheter to receive radiation.

The use of ABPI with multicatheter BT has proven to have similar results to that of WBI in a short-term study. However, the long-term effectiveness and safety of ABPI using a multicatheter BT in patients with BC treated with BCS are still unknown.

Methods & findings

or in distant organs (metastases)The study involved 1184 female patients with early BC who were treated with BCS. Patients were randomly assigned to receive either ABPI (633 patients) or WBI (551 patients). The average follow-up was 10.36 years.

At 10 years, the local recurrence rate in the ABPI group was 3.51%, and 1.58% in the WBI group. This difference was not considered statistically significant. BC recurrence in the lymph nodes at 10 years was 1.19% in the ABPI group and 0.39% in the WBI group. The occurrence of BC in distant organs (metastases) was 2.6% in the ABPI group and 2.17% in the WBI group. These differences were not considered statistically significant. 

After 10 years. 84.89% of the ABPI group and 87.95% of the WBI group were alive without BC.

Overall, fewer serious side effects were reported in the ABPI group compared to the WBI group. Fibrosis (scar tissue formation) was the most common side effect that occurred in both groups. More patients in the ABPI group reported excellent cosmetic appearance at 10 years (45%) compared to the WBI group (34%). 

The bottom line

The study concluded that ABPI with multicatheter brachytherapy was as effective and safe as WBI in women with early BC treated with BCS. 

The fine print

The study involved patients from European counties and does not represent a general population. More studies are needed to determine efficacy and safety in other ethnicities.

Published By :

The Lancet. Oncology

Date :

Feb 01, 2023

Original Title :

Accelerated partial breast irradiation using sole interstitial multicatheter brachytherapy compared with whole-breast irradiation with boost for early breast cancer: 10-year results of a GEC-ESTRO randomised, phase 3, non-inferiority trial.

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