Non-invasive image-guided breast brachytherapy (NIIGBB)[Patient Data Registry Excerpts]

David E. Wazer, MDTufts University School of Medicine

Brown University School of Medicine

A multi-institutional assessment of the A multi-institutional assessment of the feasibility, implementation, and early feasibility, implementation, and early

clinical results with noninvasive image-clinical results with noninvasive image-guided breast brachytherapy for tumor guided breast brachytherapy for tumor

bed boost.bed boost.

Subarna Hamid1,2, Kathy Rocchio2, Douglas Arthur3, Robyn Vera3, Sandra Sha4, Michele Jolly4, Sean Cavanaugh5, Eric Wooten5, Rashmi Benda6, Brad Greenfield6, Bradley Prestidge7, Scot Ackerman8, Robert Kuske9,

Coral Quiet9, Margie Snyder9 and David Wazer1,2.

1Tufts Medical Center, Boston, MA. 2Brown University, Rhode Island Hospital, Providence , RI. 3Virginia Commonwealth University, Richmond, VA. 4Central Florida

Cancer Institute, Davenport, FL . 5Atlanta Oncology Associates, Hawkinsville, GA. 6Boca Raton Community Hospital, Boca Raton, FL. 7Texas Cancer Clinic, San Antonio,

TX . 8First Coast Oncology, Jacksonville, FL. 9Arizona Breast Cancer Specialists, Phoenix, AZ

101 patients; median follow-up = 9 months (3-17 mos)

SKIN TOXICITY Grade 0 Grade 1 Grade 2

Acute Skin (1-3 wks) 59 38 7

Intermediate Skin (4-26 wks) 20 66 18

Late-interm Skin (>26 wks) 87 13 0

SUBCUTANEOUS TOXICITY Grade 0 Grade 1 Grade 2Acute SubQ (1-3 wks) 84 16 0Intermediate SubQ (4-26 wks) 83 17 0Late-interm SubQ (>26 wks) 87 13 0

% Excellent % good % fair % poor

Boost upfront 45 55 0 0

During WBRT 76 24 0 0

Preliminary cosmesis rating for ≤ 6month Preliminary cosmesis rating for ≤ 6month follow-up…follow-up…

76%

45%

24%55%

15%5%

Before WBRT During WBRT

DiscomfortComplaints

Good Cosmesis

ExcellentCosmesis

76%

45%

24%55%

15%5%

Before WBRT During WBRT

DiscomfortComplaints

Good Cosmesis

ExcellentCosmesis

Preliminary comparison of patient discomfort and ≤ 6month FU Preliminary comparison of patient discomfort and ≤ 6month FU cosmesiscosmesis

Preliminary ResultsPreliminary Results

Preliminary ConclusionsPreliminary Conclusions

• These data indicate that NIIGBB is feasible and can be consistently implemented in a broad array of practice settings.

• Preliminary evaluation suggests that NIIGBB is associated with acceptably mild normal tissue toxicity and favorable early cosmetic results.

• The application of NIIGBB before completion of WBRT may be associated with better patient tolerance at the expense of slightly less favorable cosmetic outcome.

Thank youdwazer@tuftsmedicalcenter.org