© 2004 by Oxford University Press
© 2004 Oxford University Press
COMMENTARY |
Workshop on Partial Breast Irradiation: State of the Art and the Science, Bethesda, MD, December 8–10, 2002
Author affiliations: Radiation Research Program, National Cancer Institute, National Institutes of Health, Bethesda, MD (PW, CNC); Department of Radiation Oncology, Virginia Commonwealth University-MCV Campus, Richmond, VA (DA); Antoni van Leeuwenhoek Ziekenhuis Department of Radiotherapy, Netherlands Cancer Institute, Amsterdam, The Netherlands (HB); Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA (JC); Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (GE, NG, FV, JW); John Wayne Cancer Institute, Santa Monica, CA (AG); Cancer Therapy and Research Center, San Antonio, TX (JH); Department of Human Oncology, Allegheny General Hospital, Pittsburgh, PA (TJ); Arizona Oncology Services, Scottsdale, AZ (RK); Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor, MI (AL, LP); Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (BM); Radiotherapy Department, European Institute of Oncology, Milan, Italy (RO); Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (SP); Department of Radiation Oncology, University of Pennsylvania School of Medicine (LS); Supportive Cancer Care Research Unit, Hamilton Regional Cancer Center, Hamilton, ON, Canada (TW).
Correspondence to: C. N. Coleman, MD, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bldg. 10, Rm. B3B69, MSC 1002, Bethesda, MD 20892 (e-mail: ccoleman{at}mail.nih.gov)
ABSTRACT
Breast conserving surgery followed by radiation therapy has been accepted as an alternative to mastectomy in the management of patients with early-stage breast cancer. Over the past decade there has been increasing interest in a variety of radiation techniques designed to treat only the portion of the breast deemed to be at high risk for local recurrence (partial-breast irradiation [PBI]) and to shorten the duration of treatment (accelerated partial-breast irradiation [APBI]). To consider issues regarding the equivalency of the various radiation therapy approaches and to address future needs for research, quality assurance, and training, the National Cancer Institute, Division of Cancer Treatment and Diagnosis, Radiation Research Program, hosted a Workshop on PBI in December 2002. Although 5- to 7-year outcome data on patients treated with PBI and APBI are now becoming available, many issues remain unresolved, including clinical and pathologic selection criteria, radiation dose and fractionation and how they relate to the standard fractionation for whole breast irradiation, appropriate target volume, local control within the untreated ipsilateral breast tissue, and overall survival. This Workshop report defines the issues in relation to PBI and APBI, recommends parameters for consideration in clinical trials and for reporting of results, serves to enhance dialogue among the advocates of the various radiation techniques, and emphasizes the importance of education and training in regard to results of PBI and APBI as they become emerging clinical treatments.
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