By Thomas A. Buchholz, Eric A. Strom (auth.), David E. Wazer, Douglas W. Arthur, Frank A. Vicini (eds.)
Accelerated partial breast irradiation (APBI) is being swiftly brought into the medical administration of early breast melanoma. APBI, actually, incorporates a variety of various strategies and methods that come with brachytherapy, intraoperative, and exterior beam concepts. there's presently no unmarried resource that describes those ideas and their scientific implementation. this article is a concise instruction manual designed to help the clinician within the implementation of APBI. This contains a assessment of the rules that underlie APBI, a realistic and certain description of every method for APBI, a evaluation of present scientific result of APBI, and a overview of the prevalence and administration of therapy comparable complications.
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Additional info for Accelerated Partial Breast Irradiation: Techniques and Clinical Implementation
2002; Kaufman et al. 2007) RTOG 95-17 (Arthur HDR et al. 2008) LDR Budapest, Hungary (Polgar et al. 2004) Phase I/II Trial Budapest, Hungary (Polgar et al. 2007) Phase III Trial No. cases Age (median) Size (median) Margin ER+ (%) LN− (%) 199 65 11 mm Neg 86 88 33 63 (mean) 13 mm Neg (mean) 79 91 66 34 45 62 62 56 88% T1 88% T1 12 mm Neg Neg 80 64 84 127 58 14 mm Neg 91 80 79 80 (17% cNO) 90 (5% cNO) ER+, estrogen receptor positive; LN−, negative axillary node dissection; cN0, clinically node negative, no dissection performed In addition to clinical patient selection criteria, the one additional aspect that is crucial to the implementation of APBI is a quality assurance program that ensures that a treatment target is appropriately deﬁned and dosimetrically covered within the intended prescription dose.
2003a,b; Arthur and Vicini 2004). 2 Who Is a Candidate for APBI? 29 Although its design goals have largely been achieved, additional technical aspects need to be considered in its clinical implementation. In contrast to a multicatheter implant, where the catheters are placed to conform to the target, the MammoSite RTS is placed so that the target conforms to the balloon surface. Appropriate patient selection is critically dependent upon the geometry and location of the lumpectomy cavity, and these are dependent upon the characteristics of the breast, the size of the tumor, and the communication between the surgeon and the radiation oncologist.
2003b) Limited-ﬁeld radiation therapy in the management of early-stage breast cancer. J Natl Cancer Inst 95:1205–1210 Vicini FA, Remouchamps V, Wallace M, et al. W. Arthur et al. early-stage breast cancer treated with breast-conserving therapy. Int J Radiat Oncol Biol Phys 57:1247–1253 Vicini FA, Kestin LL, Goldstein NS (2004) Deﬁning the clinical target volume for patients with early-stage breast cancer treated with lumpectomy and accelerated partial breast irradiation: a pathologic analysis.