Targeted radiation an advantage of brachytherapy. (Treatment Course Lasts 4 or 5 Days).

SAN ANTONIO -- Short-course brachytherapy offers advantages over conventional external beam irradiation in breast cancer patients undergoing breast-conserving therapy Dr. Robert R. Kuske said at the annual breast cancer symposium sponsored by the San Antonio Cancer Institute.

Through delivery of radiation through hollow plastic catheters placed around the surgical cavity, it's possible to provide as much radiation to the target zone in a 4-or 5-day course of brachytherapy as in a conventional 6-week course of whole-breast external beam irradiation entailing 25-35 trips to the clinic, said Dr. Kuske, professor of human oncology and radiation therapy at the University of Wisconsin, Madison.

Breast brachytherapy is thus far more convenient for busy working women, the frail elderly, and those who have to travel a distance for treatment. The costs are less than with conventional external radiotherapy. Local recurrence rates appear to be lower. Cosmetic outcomes are improved because the radiation dose to the skin is reduced, resulting in fewer of the rock-hard painful breasts that sometimes occur several years after external-beam radiotherapy. And brachytherapy compresses the time delay between lumpectomy and the start of postracliotherapy systemic chemotherapy, Dr. Kuske said.

He developed wide-volume breast brachytherapy 10 years ago. The hypothesis underlying the therapy is that, contrary to conventional radiation therapy teaching, the entire breast doesn't require treatment since the vast majority of in-breast recurrences following lumpectomy occur right around the lumpectomy site.

In a phase II study conducted while Dr. Kuske was at the Ochsner Clinic in New ...