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Breast Cancer • Radiation Oncology
Is there evidence to support partial breast irradiation with daily fractionation?
Since we know that both the "Canadian" fractionation and partial breast irradiation work as treatment for early stage breast cancer in the same patient population, is there any data for using Canadian fractionation (or a similar daily fractionation) to partial breast volumes? This would still be convenient for the patient and avoid possible toxicity of the high dose bid treatment.
Answer from: Radiation Oncologist at Academic Institution
As I understand it, the BID fractionation (e.g. 340 BID) that was used in the early APBI studies were largely for patient convenience. There is a potential anti-cancer benefit as well due to less repopulation during RT, but one would suspect that this is not a big effect since these brea...
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Answer from: Radiation Oncologist at Community Practice
I agree with @Lawrence B. Marks. Also, there are a number of publications that detail once daily fractionation using external beam delivery. There is a published randomized phase III trial from Florence that used 6 Gy x 5 delivered every other day. I believe this same fractionation regimen has been ...
Answer from: Radiation Oncologist at Community Practice
As @Benjamin T. Gielda mentioned, the Florence trial used 6 Gy x 5 compared to the standard arm of 50 Gy in 25 fractions follwed by a boost. At a median f/u of 5 years, LR was 1.5% in both groups. There were significant differences in acute toxicity, late events and cosmesis all favoring the AP...
Answer from: Radiation Oncologist at Academic Institution
Although it will be very interesting to see the long-term results of the NSABP B39 trial, the interim analysis of the rigorous cosmetic and toxicity assessment in the RAPID randomized controlled trial demonstrating inferior outcomes with twice daily fractionation (3.85 Gy x 10) compared with wh...
Answer from: Radiation Oncologist at Academic Institution
Another study presented at ASTRO was using START or Canadian fractionation to partial breast (September 2004 Volume 60, Issue 1, Supplement, Pages S273–S274). Since most recurrences are local and since we have data demonstrating that tolerance with these fractionatio...
Answer from: Radiation Oncologist at Academic Institution
Given some of our patient's requests, we have considered spltting the BID treatment (ie 2 days one week, three the next) instead of the 5 consecutive treatments which sometimes puts their treatments on the weekends. Any data on splitting the BID course for APBI?