scholarly journals External hypofractionated whole-breast radiotherapy: Now where does accelerated partial breast irradiation stand?

2007 ◽  
Vol 3 (4) ◽  
pp. 231 ◽  
Author(s):  
Anusheel Munshi
2005 ◽  
Vol 8 (5) ◽  
Author(s):  
L. W. Cuttino ◽  
J. R. Kelley ◽  
D. W. Arthur

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.


2009 ◽  
Vol 27 (18_suppl) ◽  
pp. CRA532-CRA532 ◽  
Author(s):  
A. Valachis ◽  
D. Mauri ◽  
N. P. Polyzos ◽  
D. Mavroudis ◽  
V. Georgoulias ◽  
...  

CRA532 Background: The purpose of the study was to compare treatment outcomes in patients with breast cancer treated with partial breast irradiation and of those treated with whole breast radiation therapy. Methods: We conducted a systematic review and meta-analysis of published. Randomized clinical trials comparing partial breast irradiation versus whole breast radiation therapy. Primary outcome was overall survival and secondary outcomes were locoregional, distant and supraclavicular recurrences. Results: A search of the literature identified 3 trials with pooled total of 1,140 patients. We found no statistically significant difference between partial and whole breast radiation arms associated with death (OR 0.912, 95% CI 0.674–1.234, p = 0.550), distant metastasis (OR 0.740, 95% CI, 0.506–1.082, p = 0.120), or supraclavicular recurrences (pooled OR 1.415, 95% CI 0.278–7.202, p = 0.560). However, partial breast irradiation was statistically significantly associated with an increased risk of both local (pooled OR 2.150, 95% CI, 1.396–3.312; p = 0.001) and regional disease recurrences (pooled OR 3.430, 95% CI, 2.058–5.715; p < 0.0001) compared with whole breast radiation. Conclusions: Partial breast irradiation does not jeopardize survival and may be used as an alternative to whole breast radiation. Nevertheless, the issue of locoregional recurrence needs to be further addressed. No significant financial relationships to disclose.


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