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Published on: 10/8/2008
Last Visited: 9/26/2008
In a second study, also expected to be presented Monday at the ASTRO conference, Dr. Peter Beitsch, a surgical oncologist at Medical City Dallas Hospital, Dallas, said that radiation "seed" implants work well as an alternative to standard whole breast radiation.He used a type of accelerated partial breast irradiation (APBI) that involves a radiation seed implant, called balloon brachytherapy.
After the tumor is surgically removed, the doctor inserts a small balloon into the cavity, attaches a catheter to the balloon, and delivers a high radiation dose by way of tiny radioactive seeds.
Beitsch used the Mammosite Radiation Therapy System, approved by the FDA in 2002.The manufacturer, which funded the study, wanted to conduct a post-approval study, he said.
Beitsch reported on 400 women (of more than 1,400 total) now followed up for almost four years.He found that the rate of early complications, such as pockets of accumulated fluid, were similar to those of patients receiving standard therapy.Cosmetic results were similar, too.
The researchers reported 28 breast tumor recurrences (about 2 percent)."The range of recurrences for whole breast radiation is nearly zero to 5 percent," Beitsch said, so these results are comparable.
The best candidates for the seed therapy, he said, are women age 45 years or older, with tumors of three centimeters or less and a diagnosis of ductal cancer or ductal cancer in situ (DCIS).About 40 percent of women diagnosed with breast cancer would probably be candidates, Beitsch estimated.
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"I disagree with his [Beitsch's] blanket assessments that recurrence is not a concern," he said.
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SOURCES: Albert Blumberg, M.D., vice chairman, radiation oncology, Greater Baltimore Medical Center, Md., and chairman, American College of Radiology Commission on Radiation Oncology; Peter Beitsch, M.D, surgical oncologist, Medical City Dallas Hospital, Dallas; Timothy Whelan, B.M., BcH., professor of oncology, McMaster University, Hamilton, Ontario, Canada; 50th annual meeting, American Society for Therapeutic Radiology and Oncology, Sept. 21-25, 2008, Boston