Impact of adjuvant systemic chemotherapy on wound healing and cosmetic outcome in 224 women treated with accelerated partial breast irradiation using interstitial brachytherapy

Publication date: Available online 27 July 2017
Source:Brachytherapy
Author(s): Ashwini Budrukkar, Prakash Pandit, Tabassum Wadasadawala, Ritu Raj Upreti, Rakesh Jalali, Sudeep Gupta, Tanuja Shet, Vani Parmar, Rajendra Badwe, Rajiv Sarin
PurposeTo evaluate the impact of timing of adjuvant chemotherapy on wound healing and cosmetic outcome in women treated with accelerated partial breast irradiation (APBI).Methods and MaterialsBetween August 2000 to December 2011, 224 women were treated with APBI using multicatheter interstitial high-dose-rate brachytherapy. Patients were treated to a dose of 34 Gy/10#/5–7 days with bid regimen. Systemic chemotherapy was administered as per the standard guidelines.ResultsMulticatheter interstitial brachytherapy technique was open cavity in 136 (60%) and closed cavity in 88 (40%). Adjuvant chemotherapy was given in 117 (52%). Wound complications (WCs) were observed in 24 patients (11%), which included wound infections (WIs) in 20 and wound dehiscence in 14. The median gap between chemotherapy and APBI was 13 days in women who developed WCs, 20 days for prechemo, and 32 days for postchemo APBI in its absence. On multivariate analysis, gap between APBI and chemotherapy of ≤3 weeks was the only significant factor (p = 0.03) affecting WCs. Acute WI (p = 0.01) and two-dimensional planning (p = 0.04) had significant impact on cosmesis resulting in fair to poor cosmetic outcome.ConclusionsGap of ≤3 weeks between APBI and chemotherapy resulted in increased WCs. WI and two-dimensional planning resulted in poorer cosmetic outcome. We recommend gap of at least 3 weeks for optimal outcome.



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