New radiotherapy delivery method reduces side effects

This study examined the effects of noninvasive image-guided breast brachytherapy using the Accuboost device.

Following surgery, high dose radiotherapy is often directed at the tumor bed to ensure the destruction of any remaining cancer cells and prevent cancer recurrence (often referred to as a "boost"). Standard external beam radiotherapy boost can deliver a high intensity beam of radiation to the tumor bed while sparing most of the surrounding healthy tissue. However, adverse effects such as skin blistering, peeling and infections are common. A new approach, referred to as noninvasive image-guided breast brachytherapy (NIBB), has the potential to significantly reduce the rate of adverse effects. NIBB employs a special device which first compresses and immobilizes the breast. Imaging of the breast is then used to direct the radiation directly to the site of the tumor bed. The current study compared the adverse effects associated with NIBB to standard external beam radiotherapy.

This study included 141 patients with early-stage breast cancer undergoing radiotherapy. 47 patients received a NIBB boost. The rate of adverse effects was compared to 94 matching patients who received a standard external beam radiotherapy boost.

Within 90 days of treatment, 52% of patients receiving standard radiotherapy developed desquamation, or peeling of the skin, compared to only 39% of patients treated with NIBB. Only one patient (2%) who received NIBB experienced significant fibrosis (scaring of breast tissue) within 15 months of treatment compared to 9 patients (9.5%) receiving standard radiotherapy. Overall, patients receiving NIBB were almost 90% less likely to experience adverse effects compared to patients receiving a standard external beam radiotherapy boost.

This study concluded that noninvasive image-guided breast brachytherapy is associated with less short term toxicity and adverse effects compared to external beam radiation.

This study only examined adverse effects following radiation therapy, in a small group of patients, and follow-up only extended for approximately one year after therapy. Therefore, the long-term effects of NIBB and its effect on the rate breast cancer recurrence cannot be determined.