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 scientific administration of early breast melanoma. APBI, actually, features a variety of assorted suggestions and ways that come with brachytherapy, intraoperative, and exterior beam concepts. there's presently no unmarried resource that describes those concepts and their medical implementation. this article is a concise guide designed to aid the clinician within the implementation of APBI. This incorporates a evaluate of the rules that underlie APBI, a pragmatic and specific description of every procedure for APBI, a evaluate of present medical result of APBI, and a overview of the occurrence and administration of therapy similar complications.
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Additional info for Accelerated Partial Breast Irradiation: Techniques and Clinical Implementation
Example text
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.
Ann Oncol 12:1075–1080 Vaidya JS, Tobias JS, Baum M, et al. (2004) Intraoperative radiotherapy for breast cancer. Lancet Oncol 5:165–173 Veronesi U, Marubini E, Mariani L, et al. (2001a) Radiotherapy after breast-conserving surgery in small breast carcinoma: long-term results of a randomized trial. Ann Oncol 12:997–1003 Veronesi U, Orecchia R, Luini A, et al. (2001b) A preliminary report of intraoperative radiotherapy (IORT) in limited-stage breast cancers that are conservatively treated. Eur J Cancer 37:2178–2183 Veronesi U, Cascinelli N, Mariani L, et al.
The contemporary studies that have addressed this question applied extensive microscopic evaluations of both mastectomy and quadrantectomy specimens and have consistently found that residual disease beyond the clinically evident primary tumor mass is most likely ductal carcinoma in situ (DCIS) (Faverly et al. 1992, 1994; Imamura et al. 2000; Ohtake et al. 1995). These studies have consistently presented evidence that suggests that the extension of tumor for most patients is limited to less than 1 cm from the primary lesion.