Current status of accelerated partial breast irradiation |
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Authors: | Michihide Mitsumori Masahiro Hiraoka |
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Institution: | (1) Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine Kyoto University, Kyoto 606-8507, Japan |
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Abstract: | Accelerated partial breast irradiation (APBI) is a radiotherapy method used in breast-conserving therapy. In APBI, the tumor
bed is topically irradiated over a short period after breast-conserving surgery. The fundamental concept underlying APBI is
that more than 70% of ipsilateral breast tumor recurrence occurs in the neighborhood of the original tumor, and that hypofractionated
radiotherapy can be applied safely when the irradiated volume is small enough. It is expected to reduce the time and cost
required for conventional whole breast irradiation while maintaining equivalent local control. Several techniques including
multicatheter interstitial brachytherapy, intracavitary brachytherapy, intraoperative radiation therapy, and 3D conformal
external beam radiation therapy have been proposed, and each of them has its own advantages and drawbacks. Although APBI is
increasingly used in the United States and Europe, and the short-term results are promising, its equivalence with whole breast
radiation therapy is not fully established. In addition, because the average breast size in Japan is considerably smaller
than in the West world, the application of APBI to Japanese patients is technically more challenging. At this point, APBI
is still an investigational treatment in Japan, and the optimal method of radiation delivery as well as its long-term efficacy
and safety should be clarified in clinical trials. |
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Keywords: | Breast cancer Breast conserving therapy Radiation therapy Accelerated partial breast irradiation |
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