Very accelerated partial breast irradiation in 1 or 2 days
Year: 2024
Type: conference-paper
Abstract: In the context of breast conservative surgery, adjuvant irradiation plays a crucial role by improving both local control and overall survival. Regarding radiation therapy regimens, one of the main subjects related to adjuvant breast irradiation has been the investigation of new hypofractioned and accelerated regimens with the goal of shortening significantly the total treatment time. Moderate hypofractionation was first investigated in the START B prospective phase 3 randomized trial (40Gy/15f/3w) following by ultra hypofractionation with the FAST-Forward phase 3 randomized trial (26Gy/5f/1w). More specifically for low-risk tumors, multicatheter interstitial brachytherapy (MIBT) is another validated option since the publication of the GEC-ESTRO phase 3 randomized trial results. As hypofractionated breast irradiation regimens was proposed to achieve more acceptable, comfortable and observable treatment, new protocols of very accelerated PBI (VAPBI) were investigated in order to perform adjuvant ultra-hypofractionated irradiation after lumpectomy in less than 4 treatment days; current results are encouraging in terms of oncological outcome as well as toxicity profile. The phase 2 TRIUMPH-T trial used a 3-fraction APBI protocol with HDR MIBT or multi-channel balloon devices. In a phase 2 prospective trial, the GEC-ESTRO tested two MIBT based VAPBI regimens over 2 to 3 days (25Gy/4f/2d or 22.35Gy/3f/2d). The single fraction was initially investigated in the SiFEBI phase 2 prospective trial by using a total dose of 16 Gy (HDR MIBT). Oncological outcome between APBI (30.1-34Gy/7-10f) and VAPBI (16Gy/1f/1d) was compared in a homogenous population of elderly women with low-risk breast cancer with no significant difference between the two patient groups regarding oncological outcome and late complication rates. VAPBI based on 1 or 2 treatment days using HDR MIBT could represent an attractive option for achieving excellent local control in a well-defined breast cancer population, avoiding, at the same time, the burden of external beam radiation therapy.
Author: Hannoun-Levi, Jean-Michel
Language: English
Subfield: Cancer Research
Domain: Life Sciences
Open Access status: green
OpenAlex ID: W6912146377
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