More Women Eligible for Accelerated Partial Breast Irradiation Under New Guidelines

More Women Eligible for Accelerated Partial Breast Irradiation Under New Guidelines
The American Society for Radiation Oncology (ASTRO) has issued an updated guideline for accelerated partial breast irradiation (APBI) in the treatment of patients with early-stage breast cancer. The free updated clinical practice statement, titled “Accelerated Partial Breast Irradiation: Executive summary for the update of an ASTRO Evidence-Based Consensus Statement,” was published in Practical Radiation Oncology and updates the 2009 ASTRO consensus statement for APBI. Drawing on recent clinical evidence showing that more patients could benefit from this accelerated therapy, the new guideline lowers the age gap considered suitable to receive APBI, includes patients with low-risk ductal carcinoma in situ (DCIS), and provides directions for the use of intraoperative radiation therapy (IORT) for partial breast irradiation. The guideline now recommends taking into account the following factors when considering APBI outside clinical trials: Patients older than 50 years old can now be considered for APBI; patients from 40 to 49 years old can be considered with caution; and patients younger than 40 not meeting the pathologic criteria should not be considered suitable. The previous practice statement recommended the age gaps to be 60 or older; ages 50-59; younger than 50, respectively. Low-risk DCIS patients can be now considered suitable if they meet all low-risk DCIS criteria. The original guideline excluded DCIS patients from the suitable group. Surgical margins remain unchanged. Patients are suitable if surgical margins are negative by less than 2 mm, cautionary if margins are close or less than 2 mm, and not suitable if margins are positive. Based on clinical trial results, the guideline also recommend the use of IORT according to the following
Subscribe or to access all post and page content.