scholarly journals Accelerated partial breast irradiation: multi-catheter interstitial brachytherapy

2005 ◽  
Vol 8 (5) ◽  
Author(s):  
L. W. Cuttino ◽  
J. R. Kelley ◽  
D. W. Arthur
Keyword(s):  
Treatment Time ◽  
Early Stage ◽  
Breast Conservation ◽  
The United States ◽  
Interstitial Brachytherapy ◽  
Accelerated Partial Breast Irradiation ◽  
Partial Breast Irradiation ◽  
Breast Irradiation ◽  
Breast Radiotherapy ◽  
Whole Breast Radiotherapy

Historically, adjuvant radiotherapy for early-stage breast cancer has included treatment of the entire breast. Breast conservation therapy (BCT), which employs whole-breast radiotherapy following lumpectomy, requires daily treatment for 5–7 weeks. The length of this treatment course proves difficult for some patients. In response, accelerated partial breast irradiation (APBI) has been investigated as a possible alternative to conventional post-lumpectomy treatment. This approach not only challenges the conventional treatment paradigm of whole-breast radiotherapy by reducing the treated volume, but also intensifies the dose delivered. By limiting the volume of breast tissue treated, the radiation dose delivery can be safely accelerated and the treatment time reduced to 5 days. In the United States, APBI has been most commonly delivered via brachytherapy (by either a multi-catheter implant or Mammosite balloon device) or by three-dimensional conformal radiotherapy (3D-CRT). One of the first techniques developed for APBI was multi-catheter interstitial brachytherapy. This article reviews completed trials of ABPI using the multi-catheter approach, as well as patient selection, placement technique, and dosimetric evaluation.

Accelerated Partial Breast Irradiation in Early-Stage Breast Cancer

2007 ◽  
Vol 25 (8) ◽  
pp. 996-1002 ◽  
Author(s):  
Mary Ella Sanders ◽  
Troy Scroggins ◽  
Federico L. Ampil ◽  
Benjamin D. Li
Keyword(s):  
Breast Cancer ◽  
Time Course ◽  
Treatment Time ◽  
Early Stage ◽  
Breast Conservation ◽  
Intraoperative Radiotherapy ◽  
Accelerated Partial Breast Irradiation ◽  
Intracavitary Brachytherapy ◽  
Partial Breast Irradiation ◽  
Breast Irradiation

Whole-breast irradiation, as part of breast-conservation therapy (BCT), has well-established results, good cosmesis, and low toxicity. Results from the BCT trials suggest that the risk for ipsilateral breast cancer recurrence resides within close proximity to the original tumor site. This leads investigators to consider the role of an accelerated and more tumor bed–focused course of radiotherapy. Accelerated partial-breast irradiation (APBI) involves treating a limited volume of breast tissue, with dose of irradiation per fraction increased and the treatment time course decreased. Four currently available methods of APBI are interstitial brachytherapy, intracavitary brachytherapy, intraoperative radiotherapy, and three-dimensional conformal external-beam radiotherapy. Patient selection is critical. This review article presents some preliminary clinical observations and limitations that suggest a potential role for APBI as a more user-friendly mode for delivering radiotherapy after lumpectomy for early breast cancer.

Accelerated Partial Breast Irradiation and Hypofractionated Whole Breast Radiation

2011 ◽  
Vol 07 (01) ◽  
pp. 31
Author(s):  
Bryan P Rowe ◽  
Meena S Moran ◽  
◽  
Keyword(s):  
Breast Cancer ◽  
Treatment Time ◽  
Early Stage ◽  
Breast Conservation ◽  
Early Stage Breast Cancer ◽  
Accelerated Partial Breast Irradiation ◽  
Partial Breast Irradiation ◽  
Breast Irradiation ◽  
Tumor Bed ◽  
Advantages And Disadvantages

Breast conservation therapy (BCT), consisting of local excision of the breast tumor to achieve negative margins followed by whole breast irradiation, is standard treatment for early-stage breast cancer. The conventional radiotherapy course treats the entire breast, typically followed by a boost to the tumor bed over six to seven weeks. While the efficacy and cosmetic outcomes of conventionally fractionated whole breast radiation are well-established, two strategies are being investigated to address the lengthy treatment time associated with adjuvant radiotherapy for early-stage breast cancer. Accelerated partial breast irradiation (APBI) involves treatment to the tumor bed plus a small margin, allowing completion of therapy in five days or less. A variety of techniques, each with unique advantages and disadvantages, is currently under investigation for delivering APBI. Hypofractionated whole breast radiation (hWBRT) involves treating the entire breast with larger daily doses of radiation over three to four weeks. This article reviews the principles behind APBI and hWBRT, the indications for each technique, and relevant data supporting their use.

scholarly journals Intraoperative Radiotherapy for Breast Cancer: The Lasting Effects of a Fleeting Treatment

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Harriet B. Eldredge-Hindy ◽  
Anne L. Rosenberg ◽  
Nicole L. Simone
Keyword(s):  
Breast Cancer ◽  
Patient Satisfaction ◽  
Early Stage ◽  
External Beam Radiotherapy ◽  
Breast Conservation ◽  
Intraoperative Radiotherapy ◽  
Ipsilateral Breast Tumor Recurrence ◽  
Partial Breast Irradiation ◽  
Breast Irradiation ◽  
Breast Radiotherapy

In well-selected patients who choose to pursue breast conservation therapy (BCT) for early-stage breast cancer, partial breast irradiation (PBI) delivered externally or intraoperatively, may be a viable alternative to conventional whole breast irradiation. Two large, contemporary randomized trials have demonstrated breast intraoperative radiotherapy (IORT) to be noninferior to whole breast external beam radiotherapy (EBRT) when assessing for ipsilateral breast tumor recurrence in select patients. Additionally, IORT and other PBI techniques are likely to be more widely adopted in the future because they improve patient convenience by offering an accelerated course of treatment. Coupled with these novel techniques for breast radiotherapy (RT) are distinct toxicity profiles and unique cosmetic alterations that differ from conventional breast EBRT and have the potential to impact disease surveillance and patient satisfaction. This paper will review the level-one evidence for treatment efficacy as well as important secondary endpoints like RT toxicity, breast cosmesis, quality of life, patient satisfaction, and surveillance mammography following BCT with IORT.

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