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Xoft Axxent® electronic brachytherapy—a new device for delivering brachytherapy to the breast

Nature Reviews Clinical Oncology volume 6, pages 138–142 (2009)Cite this article

Abstract

Balloon-based brachytherapy was developed to simplify the brachytherapy technique and make accelerated partial breast irradiation more accessible to patients with breast cancer who are suitable candidates for this technique. Xoft Axxent® (Xoft, Inc., Sunnyvale, CA) electronic brachytherapy is a novel method of accelerated partial breast irradiation that uses an electronic source to produce X-rays. Xoft Axxent® treatment does not require a high-dose-rate afterloader unit or a shielded vault, unlike other brachytherapy techniques that use iridium-192, such as MammoSite® brachytherapy. Xoft Axxent® is associated with the delivery of less radiation to normal tissues, and increased high radiation dose regions or 'hot spots' to the target volume compared with treatment with the MammoSite® device. Further research will be needed to determine subgroups of patients who might benefit from treatment with Xoft Axxent® electronic brachytherapy.

Key Points

  • Xoft Axxent® electronic brachytherapy is a form of partial breast irradiation that uses an electronic source rather than a radioisotope source

  • Xoft Axxent® electronic brachytherapy does not require a high-dose rate afterloader unit or treatment in a shielded vault

  • Xoft Axxent® is associated with an increased volume of radiation 'hot spots' and less dose to normal tissues than other forms of balloon brachytherapy

  • Further clinical research is needed with Xoft Axxent® electronic brachytherapy

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Figure 1: Diagram of a MammoSite® catheter.
Figure 2: Photo of Xoft X-ray source tube, balloon catheter, and controller.
Figure 3: Radiation dose distribution for the MammoSite (left) and Xoft Axxent® (right) methods of brachytherapy.

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References

  1. Veronesi U et al. (2002) Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 347: 1227–1232

    Article  Google Scholar 

  2. Fisher B et al. (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347: 1233–1241

    Article  Google Scholar 

  3. Cancer Trends Progress Report—2007 Update (online 2007) [http://progressreport.cancer.gov] (accessed 9 December 2008)

  4. Nattinger AB et al. (2000) Relation between appropriateness of primary therapy for early-stage breast carcinoma and increased use of breast-conserving surgery. Lancet 356: 1148–1153

    Article  CAS  Google Scholar 

  5. King TA et al. (2000) Long-term results of wide-field brachytherapy as the sole method of radiation therapy after segmental mastectomy for T(is,1,2) breast cancer. Am J Surg 180: 299–304

    Article  CAS  Google Scholar 

  6. Vicini FA et al. (2007) Long-term efficacy and patterns of failure after accelerated partial breast irradiation: a molecular assay-based clonality evaluation. Int J Radiat Oncol Biol Phys 68: 341–346

    Article  Google Scholar 

  7. Reitsamer R et al. (2006) The Salzburg concept of intraoperative radiotherapy for breast cancer: results and considerations. Int J Cancer 118: 2882–2887

    Article  CAS  Google Scholar 

  8. Polgár C et al. (2007) Breast-conserving treatment with partial or whole breast irradiation for low-risk invasive breast carcinoma—5-year results of a randomized trial. Int J Radiat Oncol Biol Phys 69: 694–702

    Article  Google Scholar 

  9. Veronesi U et al. (2005) Full-dose intraoperative radiotherapy with electrons during breast-conserving surgery: experience with 590 cases. Ann Surg 242: 101–106

    Article  Google Scholar 

  10. Vaidya JS (2007) Partial breast irradiation using targeted intraoperative radiotherapy (Targit). Nat Clin Pract Oncol 4: 384–385

    Article  Google Scholar 

  11. Samuel LM et al. (1999) A pilot study of radical radiotherapy using a perioperative implant following wide local excision for carcinoma of the breast. Breast 8: 95–97

    Article  Google Scholar 

  12. Fentiman IS et al. (1996) Inadequacy of iridium implant as sole radiation treatment for operable breast cancer. Eur J Cancer 32A: 608–611

    Article  CAS  Google Scholar 

  13. Dickler A (2007) Technology insight: MammoSite—a new device for delivering brachytherapy following breast-conserving therapy. Nat Clin Pract Oncol 4: 190–196

    Article  Google Scholar 

  14. Benitez PR et al. (2007) Five-year results: the initial clinical trial of MammoSite balloon brachytherapy for partial breast irradiation in early-stage breast cancer. Am J Surg 194: 456–462

    Article  Google Scholar 

  15. Vicini FA et al. (2008) Three-year analysis of treatment efficacy, cosmesis, and toxicity by the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial in patients treated with accelerated partial breast irradiation (APBI). Cancer 112: 758–766

    Article  Google Scholar 

  16. Kraus-Tiefenbacher U et al. (2006) Long-term toxicity of an intraoperative radiotherapy boost using low energy X-rays during breast-conserving surgery. Int J Radiat Oncol Biol Phys 66: 377–381

    Article  Google Scholar 

  17. Rivard MJ et al. (2006) Calculated and measured brachytherapy dosimetry parameters in water for the Xoft Axxent X-ray source: an electronic brachytherapy source. Med Phys 33: 4020–4032

    Article  Google Scholar 

  18. Dickler A et al. (2007) A dosimetric comparison of MammoSite high-dose-rate brachytherapy and Xoft Axxent electronic brachytherapy. Brachytherapy 6: 164–168

    Article  Google Scholar 

  19. Smitt MC and Kirby R (2007) Dose-volume characteristics of a 50-kV electronic brachytherapy source for intracavitary accelerated partial breast irradiation. Brachytherapy 6: 207–211

    Article  Google Scholar 

  20. Wazer DE et al. (2006) Accelerated partial breast irradiation: an analysis of variables associated with late toxicity and long-term cosmetic outcome after high-dose-rate interstitial brachytherapy. Int J Radiat Oncol Biol Phys 64: 489–495

    Article  Google Scholar 

  21. Mehta VK . et al. (2008) Early experience with an electronic brachytherapy technique for intracavitary accelerated partial breast irradiation [abstract #224]. Proceedings of the 2008 ASCO Breast Cancer Symposium

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Author notes

  1. Department of Radiation Oncology, Little Company of Mary Hospital, 2800 West 95th Street, Evergreen Park, IL 60805, USA atd22_99@yahoo.com

Authors and Affiliations

  1. A Dickler is a radiation oncologist in the Department of Radiation Oncology, Little Company of Mary Hospital, Evergreen Park, IL, USA.,

    Adam Dickler

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Dr Adam Dickler declared he is on the Scientific Advisory Board for Xoft, Inc.

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Dickler, A. Xoft Axxent® electronic brachytherapy—a new device for delivering brachytherapy to the breast. Nat Rev Clin Oncol 6, 138–142 (2009). https://doi.org/10.1038/ncponc1319

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