BACKGROUND AND PURPOSE: For radiobiological reasons the new concept of @entity1168 ( @entity1168 ) brachytherapy seems to be suitable to replace traditional CLDR brachytherapy with line sources. @entity1168 brachytherapy using a stepping source seems to be particularly suitable for the interstitial boost of @entity0 after breast-conserving surgery and external beam irradiation since in these cases the exact adjustment of the active lengths is essential in order to prevent unwanted skin dose and consequential unfavorable cosmetic results. The purpose of this study was to assess the feasibility and morbidity of a @entity1168 boost with flexible breast implants. MATERIALS AND METHODS: Sixty-five high risk @entity1 were treated with an interstitial @entity1168 boost. The criteria for an interstitial boost were positive margin or close margin, extensive intraductal component (EIC), intralymphatic extension, @entity1137 , T2 @entity5 and high nuclear grade (GIII). Dose calculation and specification were performed following the rules of the Paris system. The dose per pulse was 1 Gy. The pulse pauses were kept constant at 1 h. A geometrically optimized dose distribution was used for all @entity1 . The treatment schedule was 50 Gy external beam to the whole breast and 20 Gy boost. @entity1168 irradiations were carried out with a nominal 37 GBq 192-Ir source. RESULTS: The median follow-up was 30 months (minimum 12 months, maximum 54 months). Sixty percent of the @entity1 judged their cosmetic result as excellent, 27% judged it as good, 11% judged it as fair and 2% judged it as poor. Eighty-six percent of the @entity1 had no radiogenous skin changes in the boost area. In 11% of @entity1 minimal punctiform @entity8721 appeared at single puncture sites. In 3% (2/65) of @entity1 planar @entity8721 appeared on the medial side of the implant. The rate of isolated local recurrence was 1.5%. In most cases geometrical volume optimization (GVO) yields improved dose distributions with respect to homogeneity and compensation of underdosage at the margins of the implant. Only in 9% of @entity1 was the dose distribution impaired by GVO. However, GVO causes a number of substantial changes of the dose distribution which have consequences for its application. CONCLUSIONS: The interstitial CLDR boost of the breast can be replaced by the @entity1168 technique without severe @entity697 and without deterioration of the cosmetic results.

XXXX brachytherapy with flexible implants for interstitial boost after breast-conserving surgery and external beam radiation therapy.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1137 :: ('MESH:D018275', 'Disease') :: ['lobular carcinoma'] @entity697 :: ('MESH:D000208', 'Disease') :: ['acute and late complications'] @entity8721 :: ('MESH:D013684', 'Disease') :: ['telangiectasia'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast carcinoma'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumors'] @entity1168 :: ('MESH:D001919', 'Disease') :: ['PDR', 'pulsed dose rate']
@entity1168 :: (MESH:D001919,Disease) :: ['PDR']
