Conservative treatment of breast carcinoma with interstitial boost dose

A procedure is described of radiotherapy management of breast cancer using a remote control afterloading system with 192I implants combined with fractionated external irradiation. Thus, typical management of early breast cancer consists in surgery followed by a boost dose of about 20 Gy of 192I into the tumor bed and additional external beam therapy with 45 Gy in 2 Gy weekly fractions. Where necessary, chemotherapy follows after the completion of radiotherapy. The implant technique, treatment planning, source preparation and initial dosimetry are described and the specifications are given of the MicroSelectron afterloading machine from Nucletron, Holland. The calculation is explained of dose rate corrections allowing re-use of the iridium source assemblies. This also requires the application of isocentric stereo reconstructions of the implants for individualized treatment planning. The procedure is also described. (L.O.). 9 figs., 1 tab., 15 refs