Susana Pérez-Echagüen1, Camilo José Sanz-Freire2, José Luis Guinot-Rodríguez3, Cristina Gutiérrez-Miguélez4, Pilar Samper-Ots5, Víctor González-Pérez6, Elena Villafranca-Iturre7, Ignasi Modolell8, Santiago Pellejero-Pellejero9, Mauricio Cambeiro-Vázquez10, Gustavo Ossola-Lentati1. 1. Radiation Oncology Department, CIBIR - Complejo Hospitalario San Pedro La Rioja, Piqueras 98, E-26006 Logroño, Spain. 2. Medical Physics Department, CIBIR - Complejo Hospitalario San Pedro La Rioja, Piqueras 98, E-26006 Logroño, Spain. 3. Radiation Oncology Department, Fundación Instituto Valenciano de Oncología, Prof. Beltrán Báguena 8, E-46009 Valencia, Spain. 4. Radiation Oncology Department, Institut Català d'Oncologia, Avda. de la Granvia de l'Hospitalet 199-203, E-08908 L'Hospitalet de Llobregat, Barcelona, Spain. 5. Radiation Oncology Department, Hospital Universitario Rey Juan Carlos, Gladiolo s/n, E-28933 Móstoles, Madrid, Spain. 6. Medical Physics Department, Fundación Instituto Valenciano de Oncología, Prof. Beltrán Báguena 8, E-46009 Valencia, Spain. 7. Radiation Oncology Department, Complejo Hospitalario de Navarra, Irunlarrea 3, E-31008 Pamplona, Spain. 8. Servicio de Física Médica y Protección Radiológica, Institut Català d'Oncologia, Avda. de la Granvia de l'Hospitalet 199-203, E-08908 L'Hospitalet de Llobregat, Barcelona, Spain. 9. Medical Physics Department, Complejo Hospitalario de Navarra, Irunlarrea 3, E-31008 Pamplona, Spain. 10. Radiation Oncology Department, Clínica Universitaria de Navarra, Av de Pío XII 36, E-31008 Pamplona, Spain.
Abstract
AIM: To establish consensus guidelines for a safe clinical practice of accelerated partial breast irradiation (APBI) interstitial multicatheter brachytherapy (BT). BACKGROUND: APBI with interstitial multicatheter BT has proved to be effective in the treatment of early stage breast cancer. This paradigm shift in the approach to early breast cancer conservative treatment, along with the existing controversies on the clinical practice of APBI, prompted the Spanish Brachytherapy Group (GEB) of the Spanish Societies of Radiation Oncology (SEOR) and Medical Physics (SEFM) to address BT APBI in a consensus meeting. MATERIALS AND METHODS: Prior to the meeting, a survey with 27 questions on indication, inclusion criteria, BT modality, implant technique, image guidance and simulation, CTV and OAR definition, dose prescription and fractionation, dose calculation, implant quality metrics and OAR dose constrains was distributed. Items not reaching a level of agreement of 70% were discussed and voted during the meeting. RESULTS: 26 Institutions completed the survey, 60% of them perform APBI procedures. The analysis of the survey showed consensus reached on approximately half the questions. An expert panel discussed the remaining items; thereafter, a voting established the definite consensus. CONCLUSIONS: This document summarizes the consensus guidelines agreed during the meeting of the Spanish Brachytherapy Group SEOR-SEFM. Institutions with BT facilities available should offer interstitial BT APBI as a treatment option to patients fulfilling the inclusion criteria. Institutions willing to implement interstitial BT APBI are encouraged to follow the consensus guidelines established herein.
AIM: To establish consensus guidelines for a safe clinical practice of accelerated partial breast irradiation (APBI) interstitial multicatheter brachytherapy (BT). BACKGROUND: APBI with interstitial multicatheter BT has proved to be effective in the treatment of early stage breast cancer. This paradigm shift in the approach to early breast cancer conservative treatment, along with the existing controversies on the clinical practice of APBI, prompted the Spanish Brachytherapy Group (GEB) of the Spanish Societies of Radiation Oncology (SEOR) and Medical Physics (SEFM) to address BT APBI in a consensus meeting. MATERIALS AND METHODS: Prior to the meeting, a survey with 27 questions on indication, inclusion criteria, BT modality, implant technique, image guidance and simulation, CTV and OAR definition, dose prescription and fractionation, dose calculation, implant quality metrics and OAR dose constrains was distributed. Items not reaching a level of agreement of 70% were discussed and voted during the meeting. RESULTS: 26 Institutions completed the survey, 60% of them perform APBI procedures. The analysis of the survey showed consensus reached on approximately half the questions. An expert panel discussed the remaining items; thereafter, a voting established the definite consensus. CONCLUSIONS: This document summarizes the consensus guidelines agreed during the meeting of the Spanish Brachytherapy Group SEOR-SEFM. Institutions with BT facilities available should offer interstitial BT APBI as a treatment option to patients fulfilling the inclusion criteria. Institutions willing to implement interstitial BT APBI are encouraged to follow the consensus guidelines established herein.
Authors: Harry Bartelink; Philippe Maingon; Philip Poortmans; Caroline Weltens; Alain Fourquet; Jos Jager; Dominic Schinagl; Bing Oei; Carla Rodenhuis; Jean-Claude Horiot; Henk Struikmans; Erik Van Limbergen; Youlia Kirova; Paula Elkhuizen; Rudolf Bongartz; Raymond Miralbell; David Morgan; Jean-Bernard Dubois; Vincent Remouchamps; René-Olivier Mirimanoff; Sandra Collette; Laurence Collette Journal: Lancet Oncol Date: 2014-12-09 Impact factor: 41.316
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