For APBI, do you prefer a brachytherapy or external beam technique?
What specific technique (i.e. interstitial vs intracavitary, 3DCRT vs IMRT) do you prefer? What do you consider to be the pros and cons with each approach?
Answer from: Radiation Oncologist at Academic Institution
I offer a variety of PBI techniques depending on situation and patient preference.With respect to external beam, I primarily utilize a 30 Gy/5 fraction regimen delivered with VMAT (2-3 coplanar arcs). We use breath hold regardless of laterality and CBCT to reduce motion and reduce PTV expansions. Th...
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Radiation Oncologist at Mallory Radiotherapy, PLLC You mentioned using CBCT to setup patients for APB...
Radiation Oncologist at Cleveland Clinic We use ABC device and multiple breath holds to cap...
Radiation Oncologist at Varian Medical Systems/Allegheny health network With DIBH, CBCT is a challenge and most are not ab...
Radiation Oncologist at Rocky Mountain Cancer Centers-Boulder Do the respondents using 30 Gy in 5 fractions per ...
Radiation Oncologist at Lake Huron Medical Center Consecutive/Daily. I had a short exchange with @Ic...
Radiation Oncologist at Cleveland Clinic I switched to daily.
Radiation Oncologist at Cancer Care Northwest Thanks for sharing all this great info, @Chirag S....
Radiation Oncologist at Cleveland Clinic We have physicians review CBCT but at linac only o...
Radiation Oncologist at Lake Huron Medical Center I prefer having the physician check CBCT daily, bu...
Answer from: Radiation Oncologist at Academic Institution
For APBI at WashU we lean towards external beam. Over the years, the fraction of APBI patients that we elected to treat with brachytherapy has gone down from about half of our APBI volume to less than 10% largely driven by factors that @Chirag S. Shah lists. For patients eligible for APBI, we will o...
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Radiation Oncologist at Washington University School of Medicine Dr. @Imran Zoberi is very unassuming. He has a gre...
Answer from: Radiation Oncologist at Community Practice
With guidance from @Chirag S. Shah, we have treated many patients this way in our community practice with confidence and good outcomes (albeit, very short follow up). BMDACC does use somewhat different CTV volumes than CCF (which are also different than Livi), but the technique is nearly identical. ...
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Radiation Oncologist at Northeast Radiation Oncology What about breath hold/imaging?
Radiation Oncologist at Cleveland Clinic We perform our cases with breath hold (DIBH) and i...
You mentioned using CBCT to setup patients for APB...
We use ABC device and multiple breath holds to cap...
With DIBH, CBCT is a challenge and most are not ab...
Do the respondents using 30 Gy in 5 fractions per ...
Consecutive/Daily. I had a short exchange with @Ic...
I switched to daily.
Thanks for sharing all this great info, @Chirag S....
We have physicians review CBCT but at linac only o...
I prefer having the physician check CBCT daily, bu...