Level 1 evidence by prospective randomized phase III trials in multicatheter interstitial brachytherapy APBI (low dose rate—LDR or high dose rate—HDR)
| Trial . | Ptsa . | MFU (years) . | Selection criteria . | MBT type/fractionation . | LR rate (%) . | Excel/good cosmesis (%) . |
|---|---|---|---|---|---|---|
| Hungarian Trial (single institution) Polgár (28) | 130 vs. 128 (88/40) | 5.2 | T1 N0–1mi, nonlobular, no EIC, SM cleard | WBIR vs. HDR/electrons 50 Gy in 25 f vs. 36.4 Gy (7 × 5.2 Gy)c, over 4 days/50 Gy in 25 f | 3.4 in WBI vs. 4.7 in APBI (P = 0.5) | 77.6% APBI (HDR 81.2, 70% electrons) vs. 62.9% control group (52.2% telecobalt WBIR, 65.6% 6–9 MV photons (P = 0.009) |
| Hungarian Trial (single institution) Polgár (29) | 258 | 10.2 | See Polgár (28) | See Polgár (28) | 5.1 in WBI vs. 5.9 in APBI (P = 0.77) | 81% APBI vs. 63% WBIR (P < 0.01) |
| GEC-ESTRO (multi-institutional) Strnad (30) Polgár (32) | 1184 | 5 | Age ≥ 40 years, T1–2 (<3 cm), pN0-mi, SM clear >2 mmd, no LVSIb, unifocal/−centric | WBIR vs. APBI 50 + 10 boost in 30 f vs. 32 Gy (8 × 4 Gy)c, over 4 days | 0.92 in WBI vs. 1.44 in APBI (P = 0.42) | 93% APBI vs. 92% WBIR (P = 0.62) |
| Trial . | Ptsa . | MFU (years) . | Selection criteria . | MBT type/fractionation . | LR rate (%) . | Excel/good cosmesis (%) . |
|---|---|---|---|---|---|---|
| Hungarian Trial (single institution) Polgár (28) | 130 vs. 128 (88/40) | 5.2 | T1 N0–1mi, nonlobular, no EIC, SM cleard | WBIR vs. HDR/electrons 50 Gy in 25 f vs. 36.4 Gy (7 × 5.2 Gy)c, over 4 days/50 Gy in 25 f | 3.4 in WBI vs. 4.7 in APBI (P = 0.5) | 77.6% APBI (HDR 81.2, 70% electrons) vs. 62.9% control group (52.2% telecobalt WBIR, 65.6% 6–9 MV photons (P = 0.009) |
| Hungarian Trial (single institution) Polgár (29) | 258 | 10.2 | See Polgár (28) | See Polgár (28) | 5.1 in WBI vs. 5.9 in APBI (P = 0.77) | 81% APBI vs. 63% WBIR (P < 0.01) |
| GEC-ESTRO (multi-institutional) Strnad (30) Polgár (32) | 1184 | 5 | Age ≥ 40 years, T1–2 (<3 cm), pN0-mi, SM clear >2 mmd, no LVSIb, unifocal/−centric | WBIR vs. APBI 50 + 10 boost in 30 f vs. 32 Gy (8 × 4 Gy)c, over 4 days | 0.92 in WBI vs. 1.44 in APBI (P = 0.42) | 93% APBI vs. 92% WBIR (P = 0.62) |
aNot reported.
bLymphovascular invasion (LVSI).
cTwice-daily fractionation.
dSurgical margins.
Level 1 evidence by prospective randomized phase III trials in multicatheter interstitial brachytherapy APBI (low dose rate—LDR or high dose rate—HDR)
| Trial . | Ptsa . | MFU (years) . | Selection criteria . | MBT type/fractionation . | LR rate (%) . | Excel/good cosmesis (%) . |
|---|---|---|---|---|---|---|
| Hungarian Trial (single institution) Polgár (28) | 130 vs. 128 (88/40) | 5.2 | T1 N0–1mi, nonlobular, no EIC, SM cleard | WBIR vs. HDR/electrons 50 Gy in 25 f vs. 36.4 Gy (7 × 5.2 Gy)c, over 4 days/50 Gy in 25 f | 3.4 in WBI vs. 4.7 in APBI (P = 0.5) | 77.6% APBI (HDR 81.2, 70% electrons) vs. 62.9% control group (52.2% telecobalt WBIR, 65.6% 6–9 MV photons (P = 0.009) |
| Hungarian Trial (single institution) Polgár (29) | 258 | 10.2 | See Polgár (28) | See Polgár (28) | 5.1 in WBI vs. 5.9 in APBI (P = 0.77) | 81% APBI vs. 63% WBIR (P < 0.01) |
| GEC-ESTRO (multi-institutional) Strnad (30) Polgár (32) | 1184 | 5 | Age ≥ 40 years, T1–2 (<3 cm), pN0-mi, SM clear >2 mmd, no LVSIb, unifocal/−centric | WBIR vs. APBI 50 + 10 boost in 30 f vs. 32 Gy (8 × 4 Gy)c, over 4 days | 0.92 in WBI vs. 1.44 in APBI (P = 0.42) | 93% APBI vs. 92% WBIR (P = 0.62) |
| Trial . | Ptsa . | MFU (years) . | Selection criteria . | MBT type/fractionation . | LR rate (%) . | Excel/good cosmesis (%) . |
|---|---|---|---|---|---|---|
| Hungarian Trial (single institution) Polgár (28) | 130 vs. 128 (88/40) | 5.2 | T1 N0–1mi, nonlobular, no EIC, SM cleard | WBIR vs. HDR/electrons 50 Gy in 25 f vs. 36.4 Gy (7 × 5.2 Gy)c, over 4 days/50 Gy in 25 f | 3.4 in WBI vs. 4.7 in APBI (P = 0.5) | 77.6% APBI (HDR 81.2, 70% electrons) vs. 62.9% control group (52.2% telecobalt WBIR, 65.6% 6–9 MV photons (P = 0.009) |
| Hungarian Trial (single institution) Polgár (29) | 258 | 10.2 | See Polgár (28) | See Polgár (28) | 5.1 in WBI vs. 5.9 in APBI (P = 0.77) | 81% APBI vs. 63% WBIR (P < 0.01) |
| GEC-ESTRO (multi-institutional) Strnad (30) Polgár (32) | 1184 | 5 | Age ≥ 40 years, T1–2 (<3 cm), pN0-mi, SM clear >2 mmd, no LVSIb, unifocal/−centric | WBIR vs. APBI 50 + 10 boost in 30 f vs. 32 Gy (8 × 4 Gy)c, over 4 days | 0.92 in WBI vs. 1.44 in APBI (P = 0.42) | 93% APBI vs. 92% WBIR (P = 0.62) |
aNot reported.
bLymphovascular invasion (LVSI).
cTwice-daily fractionation.
dSurgical margins.
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