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Pract Radiat Oncol. 2017 Mar - Apr;7(2):73-79. doi: 10.1016/j.prro.2016.09.007. Epub 2016 Sep 17.

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

Author information

1
Department of Radiation Oncology, Faxton St. Luke's Healthcare, Utica, New York.
2
Department of Radiation Oncology, East Carolina University, Greenville, North Carolina.
3
Department of Radiation Oncology, European Institute of Oncology, Milan, Italy.
4
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
5
Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.
6
Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
7
Department of Radiation Oncology, Ohio State University Cancer Center, Columbus, Ohio.
8
Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts. Electronic address: jay_harris@dfci.harvard.edu.

Abstract

PURPOSE:

To update the accelerated partial breast irradiation Consensus Statement published in 2009 and provide guidance on use of intraoperative radiation therapy (IORT) for partial breast irradiation in early-stage breast cancer, based on published evidence complemented by expert opinion.

METHODS AND MATERIALS:

A systematic PubMed search using the same terms as the original Consensus Statement yielded 419 articles; 44 articles were selected. The authors synthesized the published evidence and, through a series of conference calls and e-mails, reached consensus regarding the recommendations.

RESULTS:

The new recommendations include lowering the age in the "suitability group" from 60 to 50 years and in the "cautionary group" to 40 years for patients who meet all other elements of suitability (Table 1). Patients with low-risk ductal carcinoma in situ, as per Radiation Therapy Oncology Group 9804 criteria, were categorized in the "suitable" group. The task force agreed to maintain the current criteria based on margin status. Recommendations for the use of IORT for breast cancer patients include: counseling patients regarding the higher risk of ipsilateral breast tumor recurrence with IORT compared with whole breast irradiation; the need for prospective monitoring of long-term local control and toxicity with low-energy radiograph IORT given limited follow-up; and restriction of IORT to women with invasive cancer considered "suitable."

CONCLUSION:

These recommendations will provide updated clinical guidance regarding use of accelerated partial breast irradiation for radiation oncologists and other specialists participating in the care of breast cancer patients.

PMID:
27866865
DOI:
10.1016/j.prro.2016.09.007
[Indexed for MEDLINE]

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