Five-Year Outcomes, Cosmesis, and Toxicity With 3-Dimensional Conformal External Beam Radiation Therapy to Deliver Accelerated Partial Breast Irradiation

Rodríguez, Núria; Sanz, X.; Dengra, J.; Arnalot, Palmira Foro; Membrive, I.; Reig, A.; Quera, J.; Fernández-Velilla, Enric; Pera, O.; Lio, J.; Lozano, J.; Algara, Manuel

doi:10.1016/j.ijrobp.2013.08.046

Cited by 158 publications

(109 citation statements)

References 26 publications

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“…29,36,37 However, other clinical series of APBI delivered with 3D-CRT or IMRT reported acceptable cosmetic outcomes. 9,[38][39][40][41][42][43][44][45] These conflicting studies raise the hypothesis that subtle variations in planning techniques and/or dose constraints may substantially modify the therapeutic ratio of EBRT-based APBI. [46][47][48] In light of ongoing research, particularly the National Surgical Adjuvant Breast and Bowel Project B-39/RTOG 0413 trial, 5 which has yet to report cosmetic outcomes for patients treated with 3D-CRT APBI, the task force opted not to make a specific recommendation either for or against the use of EBRT-based APBI at this time.…”

Section: Comment On External Beam Apbimentioning

confidence: 99%

Accelerated Partial Breast Irradiation: Executive summary for the update of an ASTRO Evidence-Based Consensus Statement

Correa

Harris

Leonardi

et al. 2017

Practical Radiation Oncology

518

342

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Section: Comment On External Beam Apbimentioning

confidence: 99%

Accelerated Partial Breast Irradiation: Executive summary for the update of an ASTRO Evidence-Based Consensus Statement

Correa

Harris

Leonardi

et al. 2017

Practical Radiation Oncology

518

342

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“…Between APBI and WBI no statistically significant differences were noted in the rates of local recurrence (both 1%) regional failure (both 1%) distant metastases (3% vs. 5%) disease free survival (87% vs. 91%), overall survival (87% vs. 93%), or cause specific survival (both 97%). To supplement, related retrospective comparisons have concluded that APBI is an effective radiation treatment modality at least equivalent to whole breast external beam radiation therapy (EBRT) [41] [76].…”

Section: Multiple Catheter Tube and Buttonmentioning

confidence: 99%

Assessment of Accelerated Partial Breast Irradiation as Monotherapy Following Breast Conserving Surgery in the Treatment of Favorable Risk Breast Cancer

Sharma¹,

Ansari²,

Churchill³

et al. 2018

ABCR

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“…One such technique is accelerated partial breast irradiation (APBI), which covers the area surrounding the lumpectomy cavity with a margin and typically is completed in one week or less [8]. Multiple studies have compared APBI with WBI and have found equivalent rates of local control and thus, APBI has emerged as a viable, safe treatment option for properly selected patients with early stage breast cancer [9,10,11,12,13]. As interest in and the utilization APBI grows, a standardized approach to treatment and workflow is necessary for many groups.…”

mentioning

confidence: 99%

Accelerated partial breast irradiation utilizing brachytherapy: patient selection and workflow

Shah¹,

Wobb²,

Manyam³

et al. 2016

jcb

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Accelerated partial breast irradiation (APBI) represents an evolving technique that is a standard of care option in appropriately selected woman following breast conserving surgery. While multiple techniques now exist to deliver APBI, interstitial brachytherapy represents the technique used in several randomized trials (National Institute of Oncology, GEC-ESTRO). More recently, many centers have adopted applicator-based brachytherapy to deliver APBI due to the technical complexities of interstitial brachytherapy. The purpose of this article is to review methods to evaluate and select patients for APBI, as well as to define potential workflow mechanisms that allow for the safe and effective delivery of APBI. Multiple consensus statements have been developed to guide clinicians on determining appropriate candidates for APBI. However, recent studies have demonstrated that these guidelines fail to stratify patients according to the risk of local recurrence, and updated guidelines are expected in the years to come. Critical elements of workflow to ensure safe and effective delivery of APBI include a multidisciplinary approach and evaluation, optimization of target coverage and adherence to normal tissue guideline constraints, and proper quality assurance methods.J PurposeBreast conserving therapy, consisting of lumpectomy followed by 6 to 7 weeks of whole breast irradiation (WBI), has been shown in multiple randomized trials to produce equivalent clinical outcomes compared to mastectomy, as well as reduced breast cancer mortality when compared to lumpectomy alone [1,2,3,4]. However, the protracted nature of treatment can pose financial and logistical hardships on patients and medical systems [5,6,7]. Therefore, there has been increased interest in developing shorter treatment courses without compromising treatment efficacy, in particular local control. One such technique is accelerated partial breast irradiation (APBI), which covers the area surrounding the lumpectomy cavity with a margin and typically is completed in one week or less [8]. Multiple studies have compared APBI with WBI and have found equivalent rates of local control and thus, APBI has emerged as a viable, safe treatment option for properly selected patients with early stage breast cancer [9,10,11,12,13]. As interest in and the utilization APBI grows, a standardized approach to treatment and workflow is necessary for many groups. The purpose of this review is to provide clinicians with a guide on patient selection and treatment workflow for patients undergoing brachytherapy-based APBI. Discussion Patient selectionSociety-specific guidelines have utilized a combination of data from patients treated with APBI, data from patients treated with WBI including patterns of failure, and expert opinion to define appropriateness criteria for the utilization of APBI off-protocol (Table 1) [14,15,16,17]. The ASTRO consensus statement, published in 2009, is one of the most commonly utilized guidelines and uses clinical and pathologic features that stratify ...

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Five-Year Outcomes, Cosmesis, and Toxicity With 3-Dimensional Conformal External Beam Radiation Therapy to Deliver Accelerated Partial Breast Irradiation

Cited by 158 publications

References 26 publications

Accelerated Partial Breast Irradiation: Executive summary for the update of an ASTRO Evidence-Based Consensus Statement

Accelerated Partial Breast Irradiation: Executive summary for the update of an ASTRO Evidence-Based Consensus Statement

Assessment of Accelerated Partial Breast Irradiation as Monotherapy Following Breast Conserving Surgery in the Treatment of Favorable Risk Breast Cancer

Accelerated partial breast irradiation utilizing brachytherapy: patient selection and workflow

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