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@ARTICLE{Forster:144833,
      author       = {T. Forster and S. Akbaba and D. Schmitt and D. Krug and R.
                      El Shafie and J. Oelmann-Avendano and K. Lindel and L.
                      König and N. Arians and D. Bernhardt and F. Marmé$^*$ and
                      A. Schneeweiss and J. Heil and C. Sohn and J. Debus$^*$ and
                      J. Hörner-Rieber$^*$},
      title        = {{S}econd breast conserving therapy after ipsilateral breast
                      tumor recurrence - a 10-year experience of re-irradiation.},
      journal      = {Journal of contemporary brachytherapy},
      volume       = {11},
      number       = {4},
      issn         = {1689-832X},
      address      = {Poznań},
      publisher    = {Termedia},
      reportid     = {DKFZ-2019-02258},
      pages        = {312 - 319},
      year         = {2019},
      abstract     = {The aim of this study is to evaluate the efficacy and
                      toxicity of post-operative partial breast re-irradiation
                      with multi-catheter brachytherapy after second breast
                      conserving therapy (BCT) in patients with small, low-risk
                      ipsilateral breast tumor recurrence (IBTR).Between 2008 and
                      2018, 19 consecutive patients with low-risk IBTR (max. rpT1
                      cN0 cM0, Her2 negative, preferably positive hormone receptor
                      status) who refused mastectomy were treated with salvage
                      lumpectomy, followed by post-operative partial breast
                      re-irradiation with multi-catheter brachytherapy. Eight
                      patients were irradiated using PDR brachytherapy (49.8-50.4
                      Gy in pulses of 0.5-0.7 Gy) and 11 patients using HDR
                      brachytherapy (34.2 Gy in fractions of 3.8 Gy or 32 Gy in
                      fractions of 4 Gy). All patients had undergone prior BCT for
                      their primary tumor, followed by adjuvant whole breast
                      radiotherapy. Local control (LC), locoregional control
                      (LRC), overall survival (OS), disease-free survival (DFS) as
                      well as toxicity were evaluated in the present study.After a
                      median follow-up of 65 months following IBTR (18-120
                      months), only one second IBTR in 19 patients was diagnosed
                      77 months after re-irradiation, resulting in a LC rate of
                      $100\%$ at 5 years. DFS and OS rates were both $100\%$ at 5
                      years following re-irradiation. Except for the above
                      mentioned second IBTR, no regional or distant relapse was
                      recorded. Regarding toxicity, $63\%$ of patients developed
                      adverse events (CTCAE grade ≤ 2), with fibrosis detected
                      in $37\%$ (7/19) of patients, necrosis in $11\%$ (2/19),
                      hyperpigmentation in $47\%$ (9/19), and telangiectasia in
                      $11\%$ (2/19), respectively. No patient showed a high-grade
                      (CTCAE grade ≥ 3) adverse event.In case of small, low-risk
                      IBTR, adjuvant re-irradiation using multi-catheter
                      brachytherapy is a feasible, safe, and effective treatment
                      method after repeated lumpectomy, and an alternative to
                      mastectomy.},
      cin          = {E050 / L101},
      ddc          = {610},
      cid          = {I:(DE-He78)E050-20160331 / I:(DE-He78)L101-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:31523231},
      pmc          = {pmc:PMC6737570},
      doi          = {10.5114/jcb.2019.87001},
      url          = {https://inrepo02.dkfz.de/record/144833},
}