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Advantages and motivations uncertain behind use of brachytherapy for breast cancer radiotherapy
Date:12/16/2011

Accelerated partial breast irradiation using brachytherapy (APBIb) for the treatment of breast cancer has been rapidly increasing over the last several years in the U.S. as an alternative to standard whole-breast irradiation (WBI), according to a study published December 16th in the Journal of the National Cancer Institute.

Various types of APBI recurrence (external beam radiation, intraoperative radiotherapy, brachytherapy using multiple interstitial catheters, or intracavitary brachytherapy using a balloon catheter) deliver radiation to breast tissue at the highest risk of recurrence. Advantages of these techniques include decreased treatment time and less radiation to uninvolved portions of the breast and normal tissues. Disadvantages of APBI include the possibility that tumor cells in a different part of the breast will remain untreated, which could lead to increased local recurrence. Because of the potential limitations of APBI, in 2009 the American Society for Radiation Oncology (ASTRO) convened a task force of breast cancer experts to develop criteria for use of APBI off-protocol. They proposed three groups of APBI appropriateness: suitable, cautionary and unsuitable, based on patient characteristics and clinical factors.

Because of the growing popularity of APBIb in particular, Jona Hattangadi, M.D., of the Department of Radiation Oncology at the Brigham and Women's Hospital and Harvard Medical School in Boston, and colleagues performed a retrospective analysis of data from the Surveillance, Epidemiology, and End Results (SEER) database of women who had received either APBIb or WBI between 2000 and 2007. In line with ASTRO guidelines, the researchers classified the 138,815 women as "suitable", "cautionary", or "unsuitable" for APBIb.

The researchers found that 3,576 of the 138,815 patients had received APBIb: 32% of whom would have been considered suitable, 29.6% cautionary, and 36.2% unsuitable. The overall use
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Contact: Zachary Rathner
Zachary.Rathner@oup.com
301-841-1286
Journal of the National Cancer Institute
Source:Eurekalert

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