Accelerated partial breast irradiation using external beam conformal radiation therapy: a review

Area of Science:

• Oncology
• Radiation Oncology
• Medical Physics

Background:

• Breast conservation therapy (BCT) is standard for early breast cancer but faces utilization challenges due to lengthy treatment durations.
• Recurrences after BCT often occur near the lumpectomy site, suggesting localized treatment potential.
• Accelerated partial breast irradiation (APBI) aims to reduce treatment time and toxicity by focusing radiation on the lumpectomy area.

Purpose of the Study:

• To review external beam conformal radiation therapy (EBCRT) techniques as a method for delivering APBI.
• To discuss the feasibility and challenges of implementing EBCRT for APBI in selected early breast cancer patients.

Main Methods:

• Review of existing literature and clinical studies on EBCRT techniques for APBI.
• Discussion of various EBCRT approaches including 3D conformal radiation therapy, IMRT, proton therapy, tomotherapy, and volumetric arc therapy.
• Analysis of implementation challenges such as target volume delineation and organ motion management.

Main Results:

• EBCRT techniques demonstrate potential for delivering APBI to a select group of early breast cancer patients.
• Various EBCRT modalities are being investigated and are in clinical trials for APBI applications.
• Key challenges for EBCRT in APBI include precise setup accuracy and managing intra-fraction motion due to breathing.

Conclusions:

• EBCRT is a viable option for APBI in carefully selected early breast cancer patients, offering a shorter treatment course.
• Further research and technological advancements are needed to overcome setup errors and motion issues for widespread EBCRT adoption in APBI.
• Optimizing EBCRT delivery will enhance the benefits of APBI, potentially improving patient convenience and outcomes.