How do you decide upon a preferred dose/fractionation scheme for breast RT?

What is you decision making process in terms of the various hypofractionated regimens for WBRT supported by different trials?

When do you favor APBI?

Are you more or less apt to provide conventional fractionation for RNI?

Answer from: Radiation Oncologist at Community Practice

Our default fractionation for all situations with or without RNI is 40 in 15 followed by boost, if indicated. If clinically and technically suitable for PBI, then preferred is 6 Gy x 5. Use 50 in 25 if inflammatory breast cancer or poor response to chemo or residual undissected node in IM or...

Comments

Radiation Oncologist at Toledo Clinic Inc.
ASTRO published guidelines for clinical suitabilit...

Radiation Oncologist at Columbia University Medical Center/ New York Presbyterian / Hudson Valley Hospital
Thanks! I guess re APBI my question is, are you us...

Radiation Oncologist at Spectrum Health-Butterworth Campus
I second Dr. @Leah Katz's question. For patients w...

Radiation Oncologist at Varian Medical Systems/Allegheny health network
All suitable, we offer APBI. Below link offers som...

Radiation Oncologist at Mercy Clinic Radiation Oncology
Agree.

Radiation Oncologist at Washington University School of Medicine
Agree with Dr. @Sushil Beriwal's opinion. Further,...

Answer from: Radiation Oncologist at Academic Institution

I prefer whole breast 42.56 Gy in 16 fx, 3D, and APBI 30 Gy in 5 fx, VMAT.APBI with VMAT since 2016 at my center -- 229 patients treated to date -- median follow-up 26 months. No toxicity. Three recurrences, all salvaged with MRM. One with pN2a axillary recurrence and multifocal IBTR (rpT1c(m)) and ...

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How do you decide upon a preferred dose/fractionation scheme for breast RT?

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