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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

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Accelerated Partial Breast Irradiation in Clinical Practice.

Frederik Wenz¹, Felix Sedlmayer², Carsten Herskind¹

¹Department of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany.

Breast Care (Basel, Switzerland)

|November 25, 2015

Summary

Accelerated partial breast irradiation (APBI) is increasingly used for select breast cancer patients. Established techniques like brachytherapy and intraoperative radiotherapy (IORT) are key to its growing application.

Keywords:

Breast cancer Intraoperative radiotherapy Partial breast irradiation Radiotherapy

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Area of Science:

Oncology
Radiotherapy
Breast Cancer Treatment

Background:

Accelerated partial breast irradiation (APBI) has been researched for over 15 years.
Clinical understanding of APBI biology, techniques, patient selection, and follow-up imaging has advanced significantly.

Purpose of the Study:

To review the current status and clinical application of APBI.
To highlight the established technical approaches and growing evidence base for APBI.

Main Methods:

Review of clinical investigation and phase III trials.
Analysis of established APBI techniques: brachytherapy, intraoperative radiotherapy (IORT), and external-beam radiotherapy.
Examination of consensus statements and patient selection criteria.

Main Results:

APBI is increasingly adopted in phase IV studies, registries, and selected patient populations.
Consensus guidelines from major societies (ASTRO, ESTRO, DEGRO) define suitable patients.
Approximately 15-25% of patients undergoing breast-conserving surgery may be candidates for APBI, particularly those with small, node-negative invasive ductal breast cancer.

Conclusions:

APBI, utilizing techniques like brachytherapy and IORT, is a viable and expanding option for selected breast cancer patients.
Further research and clinical studies are supporting the broader application of APBI.
Patient selection is crucial for successful APBI outcomes in breast-conserving surgery.