Ana Diaz Gavela, Presenter: Nothing to Disclose

Elia del Cerro Penalver, Abstract Co-Author: Nothing to Disclose

Felipe Counago, Abstract Co-Author: Nothing to Disclose

Francisco Marcos, Abstract Co-Author: Nothing to Disclose

Gines Hernandez Cortes, Abstract Co-Author: Nothing to Disclose

Lucia Gonzalez Cortijo, Abstract Co-Author: Nothing to Disclose

Juan Castro Novais, Abstract Co-Author: Nothing to Disclose

INTRODUCTION: The role of HDR brachytherapy boost in the management of breast cancer treated conservatively is more than consolidated, showing a significant decrease in local relapses in patients at risk.OBJECTIVES: To evaluate the results of this technique in our department.MATHERIALS AND METHODS: We evaluated 500 breast cancer patients who received a HDR-BTB in our department from October 2008 to July 2013. All of them were treated with external radiotherapy to the whole breast before the boost. EBRT treatment: 27.6% of the patients were treated in classical fractionation (50Gy/25 fractions) and 72.4% in a hypofractionated schedule (START B scheme: 40,05Gy/ 15 fractions). HDR-BTB prescription dose was based on the modified Paris dosimetry treatment in all patients. Location: 49.4% of the patients had left breast tumors and in 35.4% the tumor bed was located in upper external quadrant. Boost dose: 69.2% of the patients received 8Gy, 29.2% received 7Gy%, 1.4% received 10Gy and 0.2% received 12Gy. The mean implant volume (isodose of the 90% of the prescribed dose) was 8.19cc. (1.65-29.5cc). Follow up period: 27 months (6-63)RESULTS: Acute toxicity: When finishing the treatment, 1.2% of the patients presented acute bleeding (none required corrective surgery) and 1.8% suffered from local infection (mastitis in the month following treatment). Two cases of chondritis were reported. Late toxicity: 3 patients presented telangiectasia and 2 patients skin hypochromia over the implant. Regarding to fibrosis, it was absent or mild in 77.4% of the patients. The remaining patients except one showed moderate fibrosis. The only case of severe fibrosis, which required surgery, was a patient with severe cardiovascular comorbidities. 7.2% of the patients presented visible in-quadrant edema and 3.4% suffered from local pain requiring first-step analgesia. Six patients presented distant metastasis, while we observed just one local failure.CONCLUSION: HDR-BRT is a safe, fast, well tolerated and not much toxic way to administer the boost over the tumor bed in patients in indication.

Diaz Gavela, A, del Cerro Penalver, E, Counago, F, Marcos, F, Hernandez Cortes, G, Gonzalez Cortijo, L, Castro Novais, J, Single Fraction HDR Brachytherapy Boost after Conservative Surgery and Whole Breast Radiotherapy: A Single Institution Experience.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14041706.html