Abstract
Noninvasive image-guided breast brachytherapy (NIBB) is a novel APBI technique and holds potential advantages over other APBI techniques. Similar to interstitial and intracavitary brachytherapy, NIBB has the advantage of delivering radiation to the tumor bed with a high degree of precision. This is accomplished by employing breast immobilization and mammographic-like image guidance for each radiation treatment. However, unlike interstitial and intracavitary brachytherapy, NIBB is completely noninvasive making this approach more acceptable to patients not willing to undergo percutaneous catheter placement. The inconvenience and discomfort of managing an indwelling catheter or catheters is eliminated, as is the risk of instrumentation-related infection. Also, oncoplastic reconstruction to enhance the cosmetic outcomes of surgery can be performed with NIBB as long as the tissues at risk are appropriated marked with surgical clips or other fiducials. Furthermore, unlike the 3D-CRT technique, NIBB does not require an additional large margin expansion. With breast immobilization and image guidance, the inaccuracies related to set-up errors and patient or breast motion are essentially eliminated. Additionally, the breast compression used for immobilization displaces nontarget breast tissue out of the irradiation field. This results in further reduction in target and irradiated volumes, thereby reducing the risk of toxicities associated with larger treatment volumes. Altogether, this makes NIBB an attractive and promising approach for the delivery of APBI [9].
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References
Hepel JT, Wazer DE. A comparison of brachytherapy techniques for partial breast irradiation. Brachytherapy. 2012;11(3):163–75.
Arthur DW, Winter K, Kuske RR, et al. A phase II trial of brachytherapy alone after lumpectomy for select breast cancer: tumor control and survival outcomes of RTOG 95–17. Int J Radiat Oncol Biol Phys. 2008;72(2):467–73.
Hepel JT. Late toxicity and cosmetic outcomes related to interstitial multi-catheter brachytherapy for partial breast irradiation. Brachytherapy. 2014;13(1):23–6.
Shah C, Badiyan S, Ben Wilkinson J, et al. Treatment efficacy with accelerated partial breast irradiation (APBI): final analysis of the American Society of Breast Surgeons MammoSite(®) breast brachytherapy registry trial. Ann Surg Oncol. 2013;20(10):3279–85.
Hepel JT, Tokita M, MacAusland SG, et al. Toxicity of three-dimensional conformal radiotherapy for accelerated partial breast irradiation. Int J Radiat Oncol Biol Phys. 2009;75(5):1290–6.
Leonard KL, Hepel JT, Hiatt JR, et al. The effect of dose-volume parameters and interfraction interval on cosmetic outcome and toxicity after 3-dimensional conformal accelerated partial breast irradiation. Int J Radiat Oncol Biol Phys. 2013;85(3):623–9.
Jagsi R, Ben-David MA, Moran JM, et al. Unacceptable cosmesis in a protocol investigating intensity-modulated radiotherapy with active breathing control for accelerated partial-breast irradiation. Int J Radiat Oncol Biol Phys. 2010;76:71–8.
Olivotto IA, Whelan TJ, Parpia S, et al. interim cosmetic and toxicity results from RAPID: a randomized trial of accelerated partial breast irradiation using three-dimensional conformal external beam radiation therapy. J Clin Oncol. 2013;31(32):4038–45.
Hepel JT, Hiatt JR, Sha S, et al. The rationale, technique, and feasibility of partial breast irradiation using non-invasive image-guided breast brachytherapy (NIBB). Brachytherapy. 2014;13(5):493–501.
Hepel JT, Leonard KL, Hiatt JR, et al. Factors influencing eligibility for breast boost using noninvasive image-guided breast brachytherapy. Brachytherapy. 2014;13(6):579–83.
Smith LA, Kuske RR, Cross MJ. Improved targeting of the lumpectomy cavity using a spiral 3-D marker. Int J Rad Oncol Bio Phys. 2014;90(1S):S276.
Rivard MJ, Melhus CS, Wazer DE, et al. Dosimetric characterization of round HDR 192Ir AccuBoost applicators for breast brachytherapy. Med Phys. 2009;36:5027–32.
Yang Y, Melhus CS, Sioshansi S, et al. Treatment planning of a skin-sparing conical breast brachytherapy applicator using conventional brachytherapy software. Med Phys. 2011;38(3):1519–25.
Hepel JT, Leonard KL, Sha S, et al. Non-invasive image-guided breast brachytherapy (NIBB) to deliver accelerated partial breast irradiation (APBI): analysis of acute toxicity and early outcomes. Int J Rad Oncol Bio Phys. 2014;90(1S):S136.
Sioshansi S, Rivard MJ, Hiatt JR, et al. Dose modeling of noninvasive image-guided breast brachytherapy in comparison to electron beam boost and three-dimensional conformal accelerated partial breast irradiation. Int J Radiat Oncol Biol Phys. 2011;80(2):410–6.
Leonard KL, Rivard MJ, Wazer DE, et al. Prescription dose evaluation for APBI with noninvasive image-guided breast brachytherapy using equivalent uniform dose. Brachytherapy. 2015;14(4):496–501.
www.clinicaltrials.gov. NCT01961531.
Rivard MJ, Ghadyani HR, Bastien AD, et al. Multi-axis dose accumulation of noninvasive image-guided breast brachytherapy through biomechanical modeling of tissue deformation using the finite element method. J Contemp Brachytherapy. 2015;7(1):55–71.
Hiatt JR, Rava PS, Leonard KL, et al. Chest wall dose assessment in patients treated using non-invasive image-guided breast brachytherapy APBI. Brachytherapy. 2013;12(2):S47.
Hamid S, Rocchio K, Arthur D, et al. A multi-institutional study of feasibility, implementation, and early clinical results with noninvasive breast brachytherapy for tumor bed boost. Int J Radiat Oncol Biol Phys. 2012;83:1374–80.
Schuster JM, Chipko C, Saraiya S, et al. Update on a multi-institutional study of noninvasive breast brachytherapy for tumor bed boost: cosmesis and tumor control. Brachytherapy. 2014;13:S19.
Leonard KL, Hepel JT, Styczynski JR, et al. Breast boost using noninvasive image-guided breast brachytherapy vs. external beam: a 2:1 matched-pair analysis. Clin Breast Cancer. 2013;13:455–9.
Shah C, Vicini F, Wazer DE, et al. The American Brachytherapy Society consensus statement for accelerated partial breast irradiation. Brachytherapy. 2013;12(4):267–77.
Smith BD, Arthur DW, Buchholz TA, et al. Accelerated partial breast irradiation consensus statement from the American Society for Radiation Oncology (ASTRO). Int J Radiat Oncol Biol Phys. 2009;74(4):987–1001.
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Hepel, J.T. (2016). Noninvasive Image-Guided Breast Brachytherapy (NIBB). In: Arthur, D., Vicini, F., Wazer, D., Khan, A. (eds) Short Course Breast Radiotherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-24388-7_25
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DOI: https://doi.org/10.1007/978-3-319-24388-7_25
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