Resultados cosméticos de braquiterapia de alta tasa de dosis después de cirugía conservadora en pacientes con cáncer de mama

Autores/as

  • Felipe Torres Instituto Nacional de Cancerología
  • Beatriz E. Pineda Instituto Nacional de Cancerología

Palabras clave:

neoplasmas de la mama, radioterapia, cirugía, braquiterapia, estética, terapia combinada

Resumen

Objetivo: presentar los resultados cosméticos en pacientes con cáncer de mama en estadios tempranos con factores de bajo riesgo, tratadas con radioterapia parcial acelerada utilizando braquiterapia intersticial de alta tasa de dosis (HDR).
Materiales y métodos: entre marzo de 2001 y julio de 2003, en el Instituto Nacional de Cancerologia, en Bogotá (Colombia), se trataron 14 pacientes con cáncer de mama en estadios I y H con cirugía conservadora y radioterapia sobre el lecho tumoral (radioterapia parcial acelerada) utilizando implantes intersticiales con iridio 192 (braquiterapia de alta tasa de dosis) y suministrando una dosis de 32 Gy durante 4 días en 8 fracciones, dos veces al día.
Resultados: con un seguimiento promedio de 17,7 meses se encontró un resultado cosmético bueno en 71,4% de las pacientes y excelente en 14,3%. Adicionalmente, no se encontró recaída local, regional, ni a distancia en ninguna de las pacientes.
Conclusiones: en pacientes seleccionadas con cáncer de mama en estadios I y II se puede realizar el tratamiento con radioterapia parcial acelerada sobre el lecho tumoral con dosis altas durante 4 días, con resultados cosméticos entre buenos y excelentes.

Biografía del autor/a

Felipe Torres, Instituto Nacional de Cancerología

Instituto Nacional de Cancerología E.S.E., Grupo de Radioterapia, Bogotá, D. C., Colombia.

Beatriz E. Pineda, Instituto Nacional de Cancerología

Instituto Nacional de Cancerología E.S.E., Grupo de Radioterapia, Bogotá, D. C., Colombia.

Referencias bibliográficas

Pineros M, Pardo C, et al Registro institucional de Cáncer del Instituto Nacional de Cancerología E.S.E. Resultados principales 2001. Rev Colomb Cancero! 2002; 6:(3):4-49.

Fisher Bt Redmond C, et al [For the NSABP]. Lumpectomy for breast dancer: An update of the NSABP experience. J Natl Cancer Inst Monogr 1992; 11:7-13.

Veronesi U, Salvadori B, Luini A, Banfi Ay Zucali R, et al Conservative treatment of early breast cancer: Long-term results of1232 cases treated with quadrantectomy, axillary dissection, and radiotherapy. Ann Surg 1990;211: 250-259.

Fisher B, Stewart A, Bryant J, et al. Twenty-year follow-up of a randomised trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer N Eng J Med 2002; 347:1233-1241. https://doi.org/10.1056/NEJMoa022152

Blichert-Toft M, Rose C, Andersen JAA Overgaard M. [On behalf of the Danish Breast Cancer Cooperative Group]. Danish randomized trial comparing breast conservation therapy with mastectomy: Six years of life-table análisis. J Natl Cancer Inst Monogr 1992;11:19-25.

LichterA, Lippman M, Danforth D. Mastectomy vs breast-conservative therapy in the treatment of Stage I and II carcinoma of the breast: A randomized trial at the National Cancer Institute. J Clin Oncol 1992;10:976-983. https://doi.org/10.1200/JCO.1992.10.6.976

Van Dongen J, BartelinkH, Fentimen I, et al. Randomized clinical trial to assess the value of breastconserving therapy in Stage I and IIERTC10801 trial. J Natl Cancer Inst Monogr 1992;11:15-18.

Sarrazin D, Le MG, Arraigada R. Ten-year results of a randomized trial comparing a conservative treatment to mastectomy in early breast cancer. Radiother Oncol 1989;14:177-184. https://doi.org/10.1016/0167-8140(89)90165-5

Abner ÁL, Recht A, Eberlein T, Come S, et al. Prognosis following salvage mastectomy for recurrence in the breast after conservative surgery and radiation therapy for early stage breast cancer. J Clin Oncol 1993;11:44-48. https://doi.org/10.1200/JCO.1993.11.1.44

Clarque DH, Le MG, Sarrazin D, Lacombe MJ, et al. Analysis of local-regional relapses in patients with early breast cancers treated by a excision and radiotherapy: Experience of the Institute Gustave Roussy. Int J Radiat Oncol Biol Phys 1992;11:137-139. https://doi.org/10.1016/0360-3016(85)90372-4

Fourquet A, Campana, F, Zafrani B, et al Prognostic factors of breast recurrence in the conservative management of early breast cancer. A 25 years follow up. Int J Radiat Oncol Biol Phys 1989;21:269-277. https://doi.org/10.1016/0360-3016(89)90057-6

Fowble B, Solin L, Schultz D, Rubenstein J, et al. Breast recurrence, following conservative surgery and radiation: Patterns of failure, prognosis, and pathologic findings from mastectomy specimens with implications for treatment. Int J Radiat Oncol Biol Phys 1990;19: 833-842. https://doi.org/10.1016/0360-3016(90)90002-2

Haffy B, Goldberg N, FisherD, etal. Conservative surgery and prognostic implications. Int J Oncol Biol Phys 1989;17:727-732. https://doi.org/10.1016/0360-3016(89)90058-8

Kurtz J, Amalric R, Brandone H, et al. Local recurrence after breast conservative therapy: Frecuency, time course and prognosis. Cancer 1989; 63:2912-1917. https://doi.org/10.1002/1097-0142(19890515)63:10<1912::AID-CNCR2820631007>3.0.CO;2-Y

Stotter A, McNeese M, Ames F, et al. Predicting the rate and extent of locoregional failure after breast conservation therapy for early breast cancer. Cancer 1989; 64: 2217-2225. https://doi.org/10.1002/1097-0142(19891201)64:11<2217::AID-CNCR2820641106>3.0.CO;2-2

Vicini F, RechtA, Abner A, et al. Recurrence in the breast following conservative surgery andradiation therapy for early stage breast cancer. J Natl Cancer Inst 1992;11:33-39.

Fisher B, Redmond C Poisson R, etal. Eight years results of a randomized clinical trial comparing total mastecomy and lumpectomy with or without radiation in the treatment of breast cancer. N Eng J Med 1989;320:822-828. https://doi.org/10.1056/NEJM198903303201302

The Uppsala-Orebro Breast Cancer Study Group. Sector resection with or without postoperative radiotherapy for Stage I breast cancer. A randomized trial. J Natl Cancer Inst 1990;82:277-282. https://doi.org/10.1093/jnci/82.4.277

Clark RM, McCulloch PB, Levine MN, et al. A randomized clinical trial to assess the effectiveness of breast irradiation following lumpectomy and axillary resection for node-negative breast cancer. J Natl Cancer Inst 1992;84:683-689. https://doi.org/10.1093/jnci/84.9.683

Vicini F, Chen P, Fraile M, et al Low dose rate brachytherapy as the sole radiation modality in the management of patients with early stage breast cancer treated with breast conserving therapy: Preliminary results of a pilot trial. Int J Radiat Oncol Biol Phys 1997;38:301-310. https://doi.org/10.1016/S0360-3016(97)00035-7

Glicksman A, Leith J. Radiobiological considerations of brachytherapy. Oncology 1988;2-25.

Vicini F, J affray D, et al. Implementation of 3D-virtual brachytherapy in the management of breast cancer: A description of a new method of interstitial brachytherapy. Int J Radiat Oncol Biol Phys 1998; 40:629-635. https://doi.org/10.1016/S0360-3016(97)00499-9

Baglan K, Martinez A, et al. The use of high-doserate brachytherapy alone after lumpectomy in patients with early-stage breast cancer treated with breast-conserving therapy. Int J Radiat Oncol Biol Phys 2001;50:1003-1011. https://doi.org/10.1016/S0360-3016(01)01547-4

Berle Lowther D, et al. A phase I/II study of HDR brachytherapy alone for T1/T2 breast cancer. Int J Radiat Oncol Biol Phys 2001;51:55. https://doi.org/10.1016/S0360-3016(01)01833-8

Rose M, Olivotto J, et al. Conservative surgery and radiation therapy por early stage breast cancer. Long term cosmetic results. Int J Radiat Oncol Biol Phys 1989; 124:153-157. https://doi.org/10.1001/archsurg.1989.01410020023002

Fisher B, Anderson S. Conservative surgery for the management of invasive and non invasive carcinoma of breast: NSABP trials. W J Surg 1994; 18:63-69. https://doi.org/10.1007/BF00348193

Liljegren G, Holmberg L, Adami H. Sector resection with or without postoperative radiotherapy for Stage I breast cancer: Five years results of a randomized trial. J Natl Cancer Inst 1994; 86:717-722. https://doi.org/10.1093/jnci/86.9.717

Veronesi U, Luini A, Del Vecchio M. Radiotherapy after breast preserving surgery in women with localized cancer of the breast. N Eng J Med 1993; 328:1587-1591. https://doi.org/10.1056/NEJM199306033282202

Cómo citar

[1]
Torres, F. y Pineda, B.E. 2004. Resultados cosméticos de braquiterapia de alta tasa de dosis después de cirugía conservadora en pacientes con cáncer de mama. Revista Colombiana de Cancerología. 8, 1 (mar. 2004), 15–21.

Descargas

Los datos de descargas todavía no están disponibles.

Descargas

Publicado

01-03-2004

Número

Sección

Secciones sin identificar
Estadísticas de artículo
Vistas de resúmenes
Vistas de PDF
Descargas de PDF
Vistas de HTML
Otras vistas