Tumor bed boost radiotherapy in breast cancer. A review of current techniques.

Various breast boost irradiation techniques were studied and compared. The most commonly used techniques are external beam radiation therapy (EBRT) (photons or electrons) and high dose rate (HDR) interstitial brachytherapy, but recent studies have also revealed the use of advanced radiotherapy techniques, such as intensity modulated radiation therapy (IMRT), intra-operative radiation therapy (IORT), tomotherapy, and protons. The purpose of this study is to systematically review the literature concerning breast boost radiotherapy techniques, and suggest evidence based guidelines for each. A search for literature was performed in the National Library of Medicine's (PubMed) database for English-language articles published from 1st January 1990 to 5th April 2011. The key words were `breast boost radiotherapy`, `breast boost irradiation`, and `breast boost irradiation AND techniques`. Randomized trials comparing the long-term results of boost irradiation techniques, balancing the local control, and cosmesis against logistic resources, and including cost-benefit analysis are further needed.