Radiology, Vol 192, 33-36, Copyright © 1994 by Radiological Society of North America
Perioperative implantation of iridium-192 as the boost technique for stage I and II breast cancer: results of a 10-year study of 655 patients
CM Mansfield, LT Komarnicky, GF Schwartz, AL Rosenberg, L Krishnan, WR Jewell, FE Rosato, ML Moses, D Barbot and HE Cohn
Department of Radiation Oncology and Nuclear Medicine, Thomas Jefferson University Hospital, Bodine Center for Cancer Treatment, Philadelphia, PA 19107-5097.
PURPOSE: To assess the efficacy of perioperative implantation of
iridium-192 for stage I and II breast cancer. MATERIALS AND METHODS: The
authors retrospectively reviewed findings from 655 patients with stage I
and II cancer treated with conservative surgery and Ir-192 implantation
between 1982 and 1992. Hollow plastic tubes were placed in the tumor bed as
a single- or double-plane implant at lumpectomy. Ribbons with Ir-192 seeds
were inserted into the tubes 4-6 hours later. The Ir-192 was left in place
for approximately 50 hours. External-beam irradiation was given to the
whole breast 10-14 days later. RESULTS: Follow-up ranged from 2 to 146
months. The local control at 10 years for stage I and II disease was 93%
and 87%, respectively. The 10-year actuarial survival rate was 92% +/- 1
for stage I disease and 72% +/- 4 for stage II disease. The rate of
survival with no evidence of disease for stage I and II disease combined
was 82% +/- 1 at 5 years and 75% +/- 3 at 10 years. CONCLUSION:
Perioperative implantation produced excellent local control equal to that
with electron-beam therapy.
