Purpose: The purpose was to explore the role of stereotactic body radiation therapy (SBRT) in providing local control (LC) for primary breast cancer in patients unable to undergo surgery. Materials/methods: Between 2015 and 2019, 13 non-surgical candidates with 14 lesions were treated with SBRT for primary breast cancer. In 4 cases, SBRT was used after whole breast radiation therapy (WBRT; 40-50 Gy/ 20-25 fractions). SBRT dose was 30-40 Gy in 5 fractions for patients treated with SBRT alone and 25-32 Gy in 4-5 fractions for those treated with SBRT + WBRT. LC and overall survival (OS) were estimated using KaplanMeier curves. Response was also assessed using RECIST guidelines. Results: Median follow-up was 32 (range: 3.4-70.4) months. Imaging at median 2.2 (0.6-8.1) months post-SBRT showed median 43.2 % (range: 2-100 %) decrease in the largest diameter and median 68.7 % (range: 27.9-100 %) SUV reduction. There were 3 cases of local progression at 8.7-10.6 months. Estimated LC was 100 % at 6 months and 71.6 % at 12, 24 and 36 months. Estimated median OS was 100 % at 6 months, 76.9 % at 12 months, and 61.5 % at 24 and 36 months. Acute toxicity (n = 13; 92.9 %) included grade (G)1 (n = 8), G2 (n = 4), and G4 (necrosis; n = 1). Late toxicity included G2 edema (n = 1) and G4 necrosis (n = 2, including 1 consequential late effect). Only patients treated with SBRT + WBRT experienced acute/late G4 toxicity, managed with resection or steroids. Conclusions: SBRT to primary breast cancer resulted in good LC in non-surgical/metastatic patients. Although necrosis (n = 2) occurred in the SBRT + WBRT group, it was successfully salvaged.

Primary hepatic rhabdomyosarcoma is rare, making decisions regarding locoregional management with resection and/or conventional radiation difficult. We present a novel treatment approach for a pediatric patient diagnosed with rhabdomyosarcoma diffusely involving the liver. This patient underwent treatment with yttrium-90 (Y-90) microspheres followed by external beam radiation therapy (EBRT ) to residual disease, interdigitated with systemic chemotherapy. Initial post-radiation imaging showed significant response to treatment, and she experienced minimal acute toxicities and no long-term toxicities. She developed recurrent PET-avid disease 23 months after Y-90 treatment, necessitating further local and continued systemic therapies. We report on the tumor control following Y-90 and EBRT treatment.

PURPOSE: Radiotherapy with high-dose-rate (HDR) brachytherapy is used to treat nonmelanoma skin cancers. We retrospectively analyzed a hypofractionated regimen to assess its safety and efficacy in elderly patients >= 70 years. METHODS AND MATERIALS: Forty-eight patients with 67 lesions treated since 2016 with catheter-based iridium-192 HDR brachytherapy using a custom mold or three-dimensional-printed applicator met inclusion criteria. Treatment was 36 Gy in six weekly fractions. Local and locoregional control were assessed with Kaplan-Meier curves. Acute and late toxicity were graded as per Common Terminology Criteria for Adverse Events, version 5. Cosmesis was defined as "excellent" (indistinguishable from untreated skin), "good" (minimal changes), or "poor" (extensive changes). Univariate analyses were performed. RESULTS: Median age was 85.7 years, and 21 were female. Durable local control occurred in 63 lesions (94.0%), giving estimated local control of 100% at 6 months, 95.1% at 1 year, and 88.8% at 2 years. No factors were predictive of local control on univariate analysis. All experienced acute toxicity that ultimately resolved: 28.4% Grade 2 and 4.5% Grade 3. Larger treatment volume receiving >= 36 Gy was associated with increased Grade >= 2 acute toxicity. Patients experienced late Grade 2 and late Grade 4 toxicity after 6.5% treatments each. Younger age was associated with increased Grade >= 2 late toxicity. "Good" or better cosmesis occurred in 93.2%, and "poor" cosmesis was associated with lower extremities and larger lesions. CONCLUSIONS: Hypofractionated HDR brachytherapy using 36 Gy in six weekly fractions is associated with satisfactory locoregional control and cosmesis with minimal risk of severe acute or late toxicities. (c) 2021 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.