Partial Breast Irradiation for Patients With Early-Stage Invasive Breast Cancer or Ductal Carcinoma In Situ: An ASTRO Clinical Practice Guideline.

作者：S. Shaitelman, Bethany M. Anderson, D. Arthur, J. Bazan, J. Bellon, Lisa Bradfield, Charlotte E Coles, Naamit K. Gerber, M. Kathpal, Leonard Kim, C. Laronga, I. Meattini, E. Nichols, Lori J. Pierce, M. Poppe, Patricia A. Spears, Shaveta Vinayak, Timothy Whelan, Janice Lyons · 发表于：Practical Radiation Oncology · 年份：2023 · DOI：10.1016/j.prro.2023.11.001 · 被引用次数：168 · 研究领域：Medicine

PURPOSE This guideline provides evidence-based recommendations on appropriate indications and techniques for partial breast irradiation (PBI) for patients with early-stage invasive breast cancer and ductal carcinoma in situ. METHODS The American Society for Radiation Oncology (ASTRO) convened a task force to address 4 key questions focused on the appropriate indications and techniques for PBI as an alternative to whole breast irradiation (WBI) to result in similar rates of ipsilateral breast recurrence (IBR) and toxicity outcomes. Also addressed were aspects related to the technical delivery of PBI including dose-fractionation regimens, target volumes, and treatment parameters for different PBI techniques. The guideline is based on a systematic review provided by the Agency for Healthcare Research and Quality. Recommendations were created using a predefined consensus-building methodology and system for grading evidence quality and recommendation strength. RESULTS PBI delivered using 3-D conformal radiation therapy, intensity modulated radiation therapy, multicatheter brachytherapy and single-entry brachytherapy result in similar IBR as WBI with long-term follow-up. Some patient characteristics and tumor features were underrepresented in the randomized controlled trials, making it difficult to fully define IBR risks for patients with these features. Appropriate dose-fractionation regimens, target volume delineation, and treatment planning parameters for delivery of PBI are...