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 ABCR  Vol.7 No.1 , January 2018
Assessment of Accelerated Partial Breast Irradiation as Monotherapy Following Breast Conserving Surgery in the Treatment of Favorable Risk Breast Cancer
Abstract: Accelerated partial breast irradiation (APBI) has been proposed as an alternative to whole breast radiotherapy in select patients undergoing post lumpectomy radiation therapy as part of a breast conserving approach. This comprehensive review attempts to assess the current literature and identify appropriate patients as well as supportive data.
Cite this paper: Sharma, N. , Ansari, U. , Churchill, G. , Patel, K. and Feigenberg, S. (2018) Assessment of Accelerated Partial Breast Irradiation as Monotherapy Following Breast Conserving Surgery in the Treatment of Favorable Risk Breast Cancer. Advances in Breast Cancer Research, 7, 33-64. doi: 10.4236/abcr.2018.71004.
References

[1]   De Vita, L.T. and Rosenberg, S. (2008) Principles and Practice of Oncology. 8th Edition, Philadelphia, PA.

[2]   P. Leibel S. (2004) Textbook of Radiation Oncology. Saunders, Philadelphia, PA.

[3]   Perez, C., et al. (2003) Principles and Practice of Radiation Oncology. Philadelphia, PA.

[4]   (1991) NIH Consensus Development Conference Statement on the Treatment of Early-Stage Breast Cancer. Oncology (Williston Park), 5, 120-124.

[5]   Fisher, B., et al. (2002) Twenty-Year Follow-Up of a Randomized Trial Comparing Total Mastectomy, Lumpectomy, and Lumpectomy plus Irradiation for the Treatment of Invasive Breast Cancer. The New England Journal of Medicine, 347, 1233-1241.
https://doi.org/10.1056/NEJMoa022152

[6]   Veronesi, U., et al. (2002) Twenty-Year Follow-Up of a Randomized Study Comparing Breast-Conserving Surgery with Radical Mastectomy for Early Breast Cancer. The New England Journal of Medicine, 347, 1227-1232.
https://doi.org/10.1056/NEJMoa020989

[7]   Silverstein, M.J., et al. (2005) Image-Detected Breast Cancer: State of the Art Diagnosis and Treatment. Journal of the American College of Surgeons, 201, 586-597.
https://doi.org/10.1016/j.jamcollsurg.2005.05.032

[8]   Athas, W.F., et al. (2000) Travel Distance to Radiation Therapy and Receipt of Radiotherapy Following Breast-Conserving Surgery. Journal of the National Cancer Institute, 92, 269-271.
https://doi.org/10.1093/jnci/92.3.269

[9]   Hebert-Croteau, N., et al. (1999) Variations in the Treatment of Early-Stage Breast Cancer in Quebec between 1988 and 1994. CMAJ, 161, 951-955.

[10]   Du, X.F.J., Freeman, D.H., et al. (1999) Temporal and Regional Variation in the Use of Breast-Conserving Surgery and Radiotherapy for Older Women with Early-Stage Breast Cancer from 1983 to 1996. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 54, M474-M478.
https://doi.org/10.1093/gerona/54.9.M474

[11]   Hahn, C.A., et al. (2003) Breast Conservation Rates-Barriers between Tertiary Care and Community Practice. International Journal of Radiation Oncology, Biology, Physics, 55, 1196-1199.
https://doi.org/10.1016/S0360-3016(02)04475-9

[12]   Nattinger, A.B., et al. (2000) Relation between Appropriateness of Primary Therapy for Early-Stage Breast Carcinoma and Increased Use of Breast-Conserving Surgery. Lancet, 356, 1148-1153.
https://doi.org/10.1016/S0140-6736(00)02757-4

[13]   Morrow, M., et al. (2001) Factors Predicting the Use of Breast-Conserving Therapy in Stage I and II Breast Carcinoma. Journal of Clinical Oncology, 19, 2254-2262.
https://doi.org/10.1200/JCO.2001.19.8.2254

[14]   Clarke, M., et al. (2005) Effects of Radiotherapy and of Differences in the Extent of Surgery for Early Breast Cancer on Local Recurrence and 15-Year Survival: An Overview of the Randomised Trials. Lancet, 366, 2087-2106.
https://doi.org/10.1016/S0140-6736(05)67887-7

[15]   Kuske, R.R., et al. (2006) Phase II Trial of Brachytherapy alone after Lumpectomy for Select Breast Cancer: Toxicity Analysis of RTOG 95-17. International Journal of Radiation Oncology, Biology, Physics, 65, 45-51.
https://doi.org/10.1016/j.ijrobp.2005.11.027

[16]   King, T.A., et al. (2000) Long-Term Results of Wide-Field Brachytherapy as the Sole Method of Radiation Therapy after Segmental Mastectomy for T(is,1,2) Breast Cancer. The American Journal of Surgery, 180, 299-304.
https://doi.org/10.1016/S0002-9610(00)00454-2

[17]   Benitez, P.R., et al. (2007) Five-Year Results: The Initial Clinical Trial of MammoSite Balloon Brachytherapy for Partial Breast Irradiation in Early-Stage Breast Cancer. The American Journal of Surgery, 194, 456-462.
https://doi.org/10.1016/j.amjsurg.2007.06.010

[18]   Vicini, F., et al. (2008) Three-Year Analysis of Treatment Efficacy, Cosmesis, and Toxicity by the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial in Patients Treated with Accelerated Partial Breast Irradiation (APBI). Cancer, 112, 758-766.
https://doi.org/10.1002/cncr.23227

[19]   Patel, R.R., et al. (2008) Clinical Outcome Analysis in “High-Risk” versus “Low-Risk” Patients Eligible for National Surgical Adjuvant Breast and Bowel B-39/Radiation Therapy Oncology Group 0413 Trial: Five-Year Results. International Journal of Radiation Oncology, Biology, Physics, 70, 970-973.
https://doi.org/10.1016/j.ijrobp.2007.12.005

[20]   Ott, O.J., et al. (2007) Accelerated Partial Breast Irradiation with Multi-Catheter Brachytherapy: Local Control, Side Effects and Cosmetic Outcome for 274 Patients. Results of the German-Austrian Multi-Centre Trial. Radiotherapy & Oncology, 82, 281-286.
https://doi.org/10.1016/j.radonc.2006.08.028

[21]   Kaufman, S.A., et al. (2007) Long-Term Outcome and Toxicity in a Phase I/II Trial Using High-Dose-Rate Multicatheter Interstitial Brachytherapy for T1/T2 Breast Cancer. Brachytherapy, 6, 286-292.
https://doi.org/10.1016/j.brachy.2007.09.001

[22]   Arthur, D.W., et al. (2008) A Phase II Trial of Brachytherapy alone after Lumpectomy for Select Breast Cancer: Tumor Control and Survival Outcomes of RTOG 95-17. International Journal of Radiation Oncology, Biology, Physics, 72, 467-473.
https://doi.org/10.1016/j.ijrobp.2007.12.056

[23]   Polgar, C., et al. (2007) Breast-Conserving Treatment with Partial or Whole Breast Irradiation for Low-Risk Invasive Breast Carcinoma—5-Year Results of a Randomized Trial. International Journal of Radiation Oncology, Biology, Physics, 69, 694-702.
https://doi.org/10.1016/j.ijrobp.2007.04.022

[24]   (2007) The American Society of Breast Surgeons—Performance and Practice Guidelines for Stereotactic Breast Procedures.

[25]   Keisch, M., Arthur, D.W., Patel, R.R., et al. (2007) American Brachytherapy Society Breast Brachytherapy Task Group.

[26]   Sauer, R., et al. (2007) Accelerated Partial Breast Irradiation: Consensus Statement of 3 German Oncology Societies. Cancer, 110, 1187-1194.
https://doi.org/10.1002/cncr.22910

[27]   (2007) Accelerated Partial Breast Irradiation as Sole Radiotherapy after Breast-Conserving Surgery for Early Stage Breast Cancer. Technology Evaluation Center Assessment Program. Executive Summary, 22, 1-4.

[28]   Faverly, D., Holland, R. and Burgers, L. (1992) An Original Stereomicroscopic Analysis of the Mammary Glandular Tree. Virchows Archiv. A, Pathological Anatomy and Histopathology, 421, 115-119.
https://doi.org/10.1007/BF01607043

[29]   Faverly, D.R., et al. (1994) Three Dimensional Imaging of Mammary Ductal Carcinoma in Situ: Clinical Implications. Seminars in Diagnostic Pathology, 11, 193-198.

[30]   Imamura, H., et al. (2000) Relationship between the Morphological and Biological Characteristics of Intraductal Components Accompanying Invasive Ductal Breast Carcinoma and Patient Age. Breast Cancer Research and Treatment, 62, 177-184.
https://doi.org/10.1023/A:1006462328544

[31]   Ohtake, T., et al. (1995) Intraductal Extension of Primary Invasive Breast Carcinoma Treated by Breast-Conservative Surgery. Computer Graphic Three-Dimensional Reconstruction of the Mammary Duct-Lobular Systems. Cancer, 76, 32-45.
https://doi.org/10.1002/1097-0142(19950701)76:1%3C32::AID-CNCR2820760106%3E3.0.CO;2-R

[32]   Fisher, B. and Anderson, S. (1994) Conservative Surgery for the Management of Invasive and Noninvasive Carcinoma of the Breast: NSABP Trials. National Surgical Adjuvant Breast and Bowel Project. World Journal of Surgery, 18, 63-69.
https://doi.org/10.1007/BF00348193

[33]   Fisher, E.R., et al. (1999) Pathologic Findings from the National Surgical Adjuvant Breast Project (NSABP) Eight-Year Update of Protocol B-17: Intraductal Carcinoma. Cancer, 86, 429-438.
https://doi.org/10.1002/(SICI)1097-0142(19990801)86:3%3C429::AID-CNCR11%3E3.0.CO;2-Y

[34]   Holli, K., et al. (2001) Lumpectomy with or without Postoperative Radiotherapy for Breast Cancer with Favourable Prognostic Features: Results of a Randomized Study. British Journal of Cancer, 84, 164-169.
https://doi.org/10.1054/bjoc.2000.1571

[35]   Uppsala-Orbero Breast Cancer Study Group. (1990) Sector Resection with or without Postoperative Radiotherapy for Stage I Breast Cancer: A Randomized Trial. Journal of the National Cancer Institute, 82, 277-282.
https://doi.org/10.1093/jnci/82.4.277

[36]   Clark, R.M., et al. (1996) Randomized Clinical Trial of Breast Irradiation Following Lumpectomy and Axillary Dissection for Node-Negative Breast Cancer: An Update. Ontario Clinical Oncology Group. Journal of the National Cancer Institute, 88, 1659-1664.
https://doi.org/10.1093/jnci/88.22.1659

[37]   Liljegren, G., et al. (1994) Sector Resection with or without Postoperative Radiotherapy for Stage I Breast Cancer: Five-Year Results of a Randomized Trial. Uppsala-Orebro Breast Cancer Study Group. Journal of the National Cancer Institute, 86, 717-722.
https://doi.org/10.1093/jnci/86.9.717

[38]   Morrow, M. (2002) Rational Local Therapy for Breast Cancer. The New England Journal of Medicine, 347, 1270-1271.
https://doi.org/10.1056/NEJMe020112

[39]   Kuske Jr., R.R. (1999) Breast Brachytherapy. Hematology/Oncology Clinics of North America, 13, 543-558.
https://doi.org/10.1016/S0889-8588(05)70074-5

[40]   Arthur, D.W., et al. (2003) Partial Breast Brachytherapy after Lumpectomy: Low-Dose-Rate and High-Dose-Rate Experience. International Journal of Radiation Oncology, Biology, Physics, 56, 681-689.
https://doi.org/10.1016/S0360-3016(03)00120-2

[41]   Hasan, Y., et al. (2008) Image Guidance in External Beam Accelerated Partial Breast Irradiation: Comparison of Surrogates for the Lumpectomy Cavity. International Journal of Radiation Oncology, Biology, Physics, 70, 619-625.
https://doi.org/10.1016/j.ijrobp.2007.08.079

[42]   Godinez, J., et al. (2008) Breast MRI in the Evaluation of Eligibility for Accelerated Partial Breast Irradiation. AJR, 191, 272-277.
https://doi.org/10.2214/AJR.07.3465

[43]   Cuttino, L.W., Todor, D. and Arthur, D.W. (2005) CT-Guided Multi-Catheter Insertion Technique for Partial Breast Brachytherapy: Reliable Target Coverage and Dose Homogeneity. Brachytherapy, 4, 10-17.
https://doi.org/10.1016/j.brachy.2004.11.002

[44]   Chen, P.Y., et al. (2006) Long-Term Cosmetic Results and Toxicity after Accelerated Partial-Breast Irradiation: A Method of Radiation Delivery by Interstitial Brachytherapy for the Treatment of Early-Stage Breast Carcinoma. Cancer, 106, 991-999.
https://doi.org/10.1002/cncr.21681

[45]   Edmundson, G.K., et al. (2002) Dosimetric Characteristics of the MammoSite RTS, a New Breast Brachytherapy Applicator. International Journal of Radiation Oncology, Biology, Physics, 52, 1132-1139.
https://doi.org/10.1016/S0360-3016(01)02773-0

[46]   Keisch, M., et al. (2003) Initial Clinical Experience with the MammoSite Breast Brachytherapy Applicator in Women with Early-Stage Breast Cancer Treated with Breast-Conserving Therapy. International Journal of Radiation Oncology, Biology, Physics, 55, 289-293.
https://doi.org/10.1016/S0360-3016(02)04277-3

[47]   Zannis, V., et al. (2005) Descriptions and Outcomes of Insertion Techniques of a Breast Brachytherapy Balloon Catheter in 1403 Patients Enrolled in the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial. The American Journal of Surgery, 190, 530-538.
https://doi.org/10.1016/j.amjsurg.2005.06.007

[48]   Israel, P., Robbins, A.B., Shroff, P., et al. (2009) Initial Surgical Experience Evaluating Early Tolerance and Toxicities in Patients Undergoing Accelerated Partial Breast Irradiation Using the Contura Multi Lumen Balloon Breast Brachytherapy Catheter. The American Surgeon, 75, 1042-1049.

[49]   Dickler, A., et al. (2009) A Dosimetric Comparison of MammoSite and ClearPath High-Dose-Rate Breast Brachytherapy Devices. Brachytherapy, 8, 14-18.
https://doi.org/10.1016/j.brachy.2008.07.006

[50]   Yashar, C.M., et al. (2009) Initial Clinical Experience with the Strut-Adjusted Volume Implant Brachytherapy Applicator for Accelerated Partial Breast Irradiation. Brachytherapy, 8, 367-372.
https://doi.org/10.1016/j.brachy.2009.03.190

[51]   Richardson, S.L. and Pino, R. (2010) Dosimetric Effects of an Air Cavity for the SAVI Partial Breast Irradiation Applicator. Medical Physics, 37, 3919-3926.
https://doi.org/10.1118/1.3457328

[52]   Weed, D.W., et al. (2005) Accelerated Partial Breast Irradiation: A Dosimetric Comparison of Three Different Techniques. Brachytherapy, 4, 121-129.
https://doi.org/10.1016/j.brachy.2004.12.005

[53]   Baglan, K.L., et al. (2003) Accelerated Partial Breast Irradiation Using 3D Conformal Radiation Therapy (3D-CRT). International Journal of Radiation Oncology, Biology, Physics, 55, 302-311.
https://doi.org/10.1016/S0360-3016(02)03811-7

[54]   Bovi, J., et al. (2007) Comparison of Three Accelerated Partial Breast Irradiation Techniques: Treatment Effectiveness Based upon Biological Models. Radiotherapy & Oncology, 84, 226-232.
https://doi.org/10.1016/j.radonc.2007.07.004

[55]   Iaccarino, G., et al. (2007) Single Fraction Partial Breast Irradiation in Prone Position. Journal of Experimental & Clinical Cancer Research, 26, 543-552.

[56]   Kozak, K.R., et al. (2006) Accelerated Partial-Breast Irradiation Using Proton Beams: Initial Clinical Experience. International Journal of Radiation Oncology, Biology, Physics, 66, 691-698.
https://doi.org/10.1016/j.ijrobp.2006.06.041

[57]   Langen, K.M., et al. (2008) Investigation of Accelerated Partial Breast Patient Alignment and Treatment with Helical Tomotherapy Unit. International Journal of Radiation Oncology, Biology, Physics, 70, 1272-1280.
https://doi.org/10.1016/j.ijrobp.2007.11.019

[58]   Leonard, C.E., et al. (2011) Accelerated Partial Breast Intensity-Modulated Radiotherapy in Women Who Have Prior Breast Augmentation. Clinical Breast Cancer, 11, 184-190.
https://doi.org/10.1016/j.clbc.2011.03.016

[59]   Chen, P.Y., et al. (2010) Four-Year Efficacy, Cosmesis, and Toxicity Using Three-Dimensional Conformal External Beam Radiation Therapy to Deliver Accelerated Partial Breast Irradiation. International Journal of Radiation Oncology, Biology, Physics, 76, 991-997.
https://doi.org/10.1016/j.ijrobp.2009.03.012

[60]   Vicini, F., et al. (2010) Initial Efficacy Results of RTOG 0319: Three-Dimensional Conformal Radiation Therapy (3D-CRT) Confined to the Region of the Lumpectomy Cavity for Stage I/ II Breast Carcinoma. International Journal of Radiation Oncology, Biology, Physics, 77, 1120-1127.
https://doi.org/10.1016/j.ijrobp.2009.06.067

[61]   Goyal, S., et al. (2013) Three-Year Outcomes of a Once Daily Fractionation Scheme for Accelerated Partial Breast Irradiation (APBI) Using 3-D Conformal Radiotherapy (3D-CRT). Cancer Medicine, 2, 964-971.
https://doi.org/10.1002/cam4.157

[62]   Reeder, R., et al. (2009) Predictors for Clinical Outcomes after Accelerated Partial Breast Intensity-Modulated Radiotherapy. International Journal of Radiation Oncology, Biology, Physics, 74, 92-97.
https://doi.org/10.1016/j.ijrobp.2008.06.1917

[63]   Jagsi, R., et al. (2010) Unacceptable Cosmesis in a Protocol Investigating Intensity-Modulated Radiotherapy with Active Breathing Control for Accelerated Partial-Breast Irradiation. International Journal of Radiation Oncology, Biology, Physics, 76, 71-78.
https://doi.org/10.1016/j.ijrobp.2009.01.041

[64]   Hepel, J.T., et al. (2009) Toxicity of Three-Dimensional Conformal Radiotherapy for Accelerated Partial Breast Irradiation. International Journal of Radiation Oncology, Biology, Physics, 75, 1290-1296.
https://doi.org/10.1016/j.ijrobp.2009.01.009

[65]   Lei, R.Y., et al. (2013) Four-Year Clinical Update from a Prospective Trial of Accelerated Partial Breast Intensity-Modulated Radiotherapy (APBIMRT). Breast Cancer Research and Treatment, 140, 119-133.
https://doi.org/10.1007/s10549-013-2623-x

[66]   Beitsch, P.D., et al. (2010) Post-Surgical Treatment of Early-Stage Breast Cancer with Electronic Brachytherapy: An Intersociety, Multicenter Brachytherapy Trial. OncoTargets and Therapy, 3, 211-218.
https://doi.org/10.2147/OTT.S14514

[67]   Pignol, J.P., et al. (2009) Tolerance and Acceptance Results of a Palladium-103 Permanent Breast Seed Implant Phase I/II Study. International Journal of Radiation Oncology, Biology, Physics, 73, 1482-1488.
https://doi.org/10.1016/j.ijrobp.2008.06.1945

[68]   Afsharpour, H., et al. (2010) Influence of Breast Composition and Interseed Attenuation in Dose Calculations for Post-Implant Assessment of Permanent Breast 103Pd Seed Implant. Physics in Medicine & Biology, 55, 4547-4561.
https://doi.org/10.1088/0031-9155/55/16/S09

[69]   Veronesi, U., et al. (2003) Full-Dose Intraoperative Radiotherapy with Electrons during Breast-Conserving Surgery. Archives of Surgery, 138, 1253-1256.
https://doi.org/10.1001/archsurg.138.11.1253

[70]   Veronesi, U., et al. (2001) A Preliminary Report of Intraoperative Radiotherapy (IORT) in Limited-Stage Breast Cancers That Are Conservatively Treated. European Journal of Cancer, 37, 2178-2183.
https://doi.org/10.1016/S0959-8049(01)00285-4

[71]   Kraus-Tiefenbacher, U., et al. (2005) Intraoperative Radiotherapy (IORT) for Breast Cancer Using the Intrabeam System. Tumori, 91, 339-345.

[72]   Vaidya, J.S., et al. (2002) The Novel Technique of Delivering Targeted Intraoperative Radiotherapy (Targit) for Early Breast Cancer. European Journal of Surgical Oncology, 28, 447-454.
https://doi.org/10.1053/ejso.2002.1275

[73]   Vicini, F.A., et al. (2007) Long-Term Efficacy and Patterns of Failure after Accelerated Partial Breast Irradiation: A Molecular Assay-Based Clonality Evaluation. International Journal of Radiation Oncology, Biology, Physics, 68, 341-346.
https://doi.org/10.1016/j.ijrobp.2006.12.007

[74]   Vicini, F.A., et al. (2003) Limited-Field Radiation Therapy in the Management of Early-Stage Breast Cancer. Journal of the National Cancer Institute, 95, 1205-1210.
https://doi.org/10.1093/jnci/djg023

[75]   Goldstein, N.S., et al. (2005) Molecular Clonality Determination of Ipsilateral Recurrence of Invasive Breast Carcinomas after Breast-Conserving Therapy: Comparison with Clinical and Biologic Factors. American Journal of Clinical Pathology, 123, 679-689.
https://doi.org/10.1309/DP47PK9PVC52AU4R

[76]   Rodriguez, N., et al. (2013) Five-Year Outcomes, Cosmesis, and Toxicity with 3-Dimensional Conformal External Beam Radiation Therapy to Deliver Accelerated Partial Breast Irradiation. International Journal of Radiation Oncology, Biology, Physics, 87, 1051-1057.
https://doi.org/10.1016/j.ijrobp.2013.08.046

[77]   Polgar, C., et al. (2004) High-Dose-Rate Brachytherapy Alone versus Whole Breast Radiotherapy with or without Tumor Bed Boost after Breast-Conserving Surgery: Seven-Year Results of a Comparative Study. International Journal of Radiation Oncology, Biology, Physics, 60, 1173-1181.
https://doi.org/10.1016/j.ijrobp.2004.05.012

[78]   Polgar, C., et al. (2002) Sole Brachytherapy of the Tumor Bed after Conservative Surgery for T1 Breast Cancer: Five-Year Results of a Phase I-II Study and Initial Findings of a Randomized Phase III Trial. Journal of Surgical Oncology, 80, 121-129.
https://doi.org/10.1002/jso.10110

[79]   Strnad, V., Ott, O.J., Hildebrandt, G., Kauer-Dorner, D., Knauerhase, H., Major, T., et al. (2016) 5-Year Results of Accelerated Partial Breast Irradiation Using Sole Interstitial Multicatheter Brachytherapy versus Whole-Breast Irradiation with Boost After Breast-Conserving Surgery for Low-Risk Invasive and In-Situ Carcinoma of the Female Breast: A Randomised, Phase 3, Non-Inferiority Trial. The Lancet, 387, 229-238.
https://doi.org/10.1016/S0140-6736(15)00471-7

[80]   Shaitelman, S.F., Amendola, B., Khan, A., Beriwal, S., Rabinovitch, R., Demanes, D.J. and Cuttino, L. (2016) American Brachytherapy Society Task Group Report: Long-Term Control and Toxicity with Brachytherapy for Localized Breast Cancer. Brachytherapy.

[81]   Yashar, C., Attai, D., Butler, E., Einck, J., Finkelstein, S., Han, B., et al. (2016) Strut-Based Accelerated Partial Breast Irradiation: Report of Treatment Results for 250 Consecutive Patients at 5 Years from a Multicenter Retrospective Study. Brachytherapy, 15, 780-787.
https://doi.org/10.1016/j.brachy.2016.07.002

[82]   Lawenda, B.D., et al. (2003) Dose-Volume Analysis of Radiotherapy for T1N0 Invasive Breast Cancer Treated by Local Excision and Partial Breast Irradiation by Low-Dose-Rate Interstitial Implant. International Journal of Radiation Oncology, Biology, Physics, 56, 671-680.
https://doi.org/10.1016/S0360-3016(03)00071-3

[83]   Vicini, F.A., et al. (2005) First Analysis of Patient Demographics, Technical Reproducibility, Cosmesis, and Early Toxicity: Results of the American Society of Breast Surgeons MammoSite Breast Brachytherapy Trial. Cancer, 104, 1138-1148.
https://doi.org/10.1002/cncr.21289

[84]   Cuttino, L.W., et al. (2008) Multi-Institutional Experience Using the MammoSite Radiation Therapy System in the Treatment of Early-Stage Breast Cancer: 2-Year Results. International Journal of Radiation Oncology, Biology, Physics, 71, 107-114.
https://doi.org/10.1016/j.ijrobp.2007.09.046

[85]   Beitsch, P.D., Zannis, V., et al. (2008) Recurrence and Survival in the American Society of Breast Surgeons (ASBS) MammoSite RTS Registry Trial. International Journal of Radiation Oncology, Biology, Physics, 72, S2-S3.
https://doi.org/10.1016/j.ijrobp.2008.06.773

[86]   Belkacemi, Y., et al. (2009) Partial Breast Irradiation as Sole Therapy for Low Risk Breast Carcinoma: Early Toxicity, Cosmesis and Quality of Life Results of a MammoSite Brachytherapy Phase II Study. Radiotherapy & Oncology, 90, 23-29.
https://doi.org/10.1016/j.radonc.2008.06.004

[87]   Chao, K.K., et al. (2007) Analysis of Treatment Efficacy, Cosmesis, and Toxicity Using the MammoSite Breast Brachytherapy Catheter to Deliver Accelerated Partial-Breast Irradiation: The William Beaumont Hospital Experience. International Journal of Radiation Oncology, Biology, Physics, 69, 32-40.
https://doi.org/10.1016/j.ijrobp.2007.02.026

[88]   Shah, C., et al. (2013) Treatment Efficacy with Accelerated Partial Breast Irradiation (APBI): Final Analysis of the American Society of Breast Surgeons MammoSite((R)) Breast Brachytherapy Registry Trial. Annals of Surgical Oncology, 20, 3279-3285.
https://doi.org/10.1245/s10434-013-3158-4

[89]   Formenti, S.C., et al. (2002) T1 Stage Breast Cancer: Adjuvant Hypofractionated Conformal Radiation Therapy to Tumor Bed in Selected Postmenopausal Breast Cancer Patients—Pilot Feasibility Study. Radiology, 222, 171-178.
https://doi.org/10.1148/radiol.2221010769

[90]   Remouchamps, V.M., et al. (2003) Three-Dimensional Evaluation of Intra- and Interfraction Immobilization of Lung and Chest wall Using Active Breathing Control: A Reproducibility Study with Breast Cancer Patients. International Journal of Radiation Oncology, Biology, Physics, 57, 968-978.
https://doi.org/10.1016/S0360-3016(03)00710-7

[91]   Rusthoven, K.E., et al. (2008) Accelerated Partial-Breast Intensity-Modulated Radiotherapy Results in Improved Dose Distribution When Compared with Three-Dimensional Treatment-Planning Techniques. International Journal of Radiation Oncology, Biology, Physics, 70, 296-302.
https://doi.org/10.1016/j.ijrobp.2007.08.047

[92]   White, E.A., et al. (2007) Cone Beam Computed Tomography Guidance for Setup of Patients Receiving Accelerated Partial Breast Irradiation. International Journal of Radiation Oncology, Biology, Physics, 68, 547-554.
https://doi.org/10.1016/j.ijrobp.2007.01.048

[93]   Patel, R.R., et al. (2007) A Dosimetric Comparison of Accelerated Partial Breast Irradiation Techniques: Multicatheter Interstitial Brachytherapy, Three-Dimensional Conformal Radiotherapy, and Supine Versus Prone Helical Tomotherapy. International Journal of Radiation Oncology, Biology, Physics, 68, 935-942.
https://doi.org/10.1016/j.ijrobp.2007.03.005

[94]   Whelan, T.J., et al. (2010) Long-Term Results of Hypofractionated Radiation Therapy for Breast Cancer. The New England Journal of Medicine, 362, 513-520.
https://doi.org/10.1056/NEJMoa0906260

[95]   Taghian, A.G., et al. (2006) Initial Dosimetric Experience Using Simple Three-Dimensional Conformal External-Beam Accelerated Partial-Breast Irradiation. International Journal of Radiation Oncology, Biology, Physics, 64, 1092-1099.
https://doi.org/10.1016/j.ijrobp.2005.09.042

[96]   Vicini, F.A., et al. (2007) Interim Cosmetic Results and Toxicity Using 3d Conformal External Beam Radiotherapy to Deliver Accelerated Partial Breast Irradiation in Patients with Early-Stage Breast Cancer Treated with Breast-Conserving Therapy. International Journal of Radiation Oncology, Biology, Physics, 69, 1124-1130.
https://doi.org/10.1016/j.ijrobp.2007.04.033

[97]   Zelefsky, M.J., et al. (2008) Incidence of Late Rectal and Urinary Toxicities after Three-Dimensional Conformal Radiotherapy and Intensity-Modulated Radiotherapy for Localized Prostate Cancer. International Journal of Radiation Oncology, Biology, Physics, 70, 1124-1129.
https://doi.org/10.1016/j.ijrobp.2007.11.044

[98]   Sheets, N.C., et al. (2012) Intensity-Modulated Radiation Therapy, Proton Therapy, or Conformal Radiation Therapy and Morbidity and Disease Control in Localized Prostate Cancer. JAMA, 307, 1611-1120.
https://doi.org/10.1001/jama.2012.460

[99]   Pignol, J.P., et al. (2008) A Multicenter Randomized Trial of Breast Intensity-Modulated Radiation Therapy to Reduce Acute Radiation Dermatitis. Journal of Clinical Oncology, 26, 2085-2092.
https://doi.org/10.1200/JCO.2007.15.2488

[100]   Barnett, G.C., et al. (2009) A Randomised Controlled Trial of Forward-Planned Radiotherapy (IMRT) for Early Breast Cancer: Baseline Characteristics and Dosimetry Results. Radiotherapy & Oncology, 92, 34-41.
https://doi.org/10.1016/j.radonc.2009.03.003

[101]   Harsolia, A., et al. (2007) Intensity-Modulated Radiotherapy Results in Significant Decrease in Clinical Toxicities Compared with Conventional Wedge-Based Breast Radiotherapy. International Journal of Radiation Oncology, Biology, Physics, 68, 1375-1380.
https://doi.org/10.1016/j.ijrobp.2007.02.044

[102]   Sharma, N.K., et al. (2011) Intensity-Modulated Radiotherapy Reduces Gastrointestinal Toxicity in Patients Treated with Androgen Deprivation Therapy for Prostate Cancer. International Journal of Radiation Oncology, Biology, Physics, 80, 437-444.
https://doi.org/10.1016/j.ijrobp.2010.02.040

[103]   Bergom, C., et al. (2013) A Phase I/II Study Piloting Accelerated Partial Breast Irradiation Using CT-Guided Intensity Modulated Radiation Therapy in the Prone Position. Radiotherapy & Oncology, 108, 215-219.
https://doi.org/10.1016/j.radonc.2013.05.039

[104]   Polgár, C., Fodor, J., Major, T., Sulyok, Z. and Kásler, M. (2013) Breast-Conserving Therapy with Partial or Whole Breast Irradiation: Ten-Year Results of the Budapest Randomized Trial. Radiotherapy & Oncology, 108, 197-202.
https://doi.org/10.1016/j.radonc.2013.05.008

[105]   Livi, L., Meattini, I., Marrazzo, L., Simontacchi, G., Pallotta, S., Saieva, C., et al. (2015) Accelerated Partial Breast Irradiation Using Intensity-Modulated Radiotherapy versus Whole Breast Irradiation: 5-Year Survival Analysis of a Phase 3 Randomised Controlled Trial. European Journal of Cancer, 51, 451-463.
https://doi.org/10.1016/j.ejca.2014.12.013

[106]   Coles, C., Agrawal, R., Ah-See, M.L., et al. (2016) Partial Breast Radiotherapy for Women with Early Breast Cancer: First Results of Local Recurrence Data for IMPORT-LOW (CRUK/06/003). European Journal of Cancer, 57, S4.

[107]   Vicini, F.A., et al. (2003) Ongoing Clinical Experience Utilizing 3D Conformal External Beam Radiotherapy to Deliver Partial-Breast Irradiation in Patients with Early-Stage Breast Cancer Treated with Breast-Conserving Therapy. International Journal of Radiation Oncology, Biology, Physics, 57, 1247-1253.
https://doi.org/10.1016/S0360-3016(03)01573-6

[108]   Pashtan, I.M., et al. (2012) External Beam Accelerated Partial-Breast Irradiation Using 32 gy in 8 Twice-Daily Fractions: 5-Year Results of a Prospective Study. International Journal of Radiation Oncology, Biology, Physics, 84, e271-e277.
https://doi.org/10.1016/j.ijrobp.2012.04.019

[109]   Vaidya, J.S., et al. (2005) TARGeted Intraoperative Radiotherapy (TARGIT): An Innovative Approach to Partial-Breast Irradiation. Seminars in Radiation Oncology, 15, 84-91.
https://doi.org/10.1016/j.semradonc.2004.10.007

[110]   Veronesi, U., et al. (2008) Full-Dose Intra-Operative Radiotherapy with Electrons (ELIOT) during Breast-Conserving Surgery: Experience with 1246 Cases. Ecancermedicalscience, 2, 65.

[111]   Vaidya, J.S., et al. (2001) Targeted Intra-Operative Radiotherapy (Targit): An Innovative Method of Treatment for Early Breast Cancer. Annals of Oncology, 12, 1075-1080.
https://doi.org/10.1023/A:1011609401132

[112]   Vaidya, J.S., et al. (2014) Risk-Adapted Targeted Intraoperative Radiotherapy versus Whole-Breast Radiotherapy for Breast Cancer: 5-Year Results for Local Control and Overall Survival from the TARGIT-A Randomised Trial. Lancet, 383, 603-613.
https://doi.org/10.1016/S0140-6736(13)61950-9

[113]   Holmes, D.R., Baum, M. and Joseph, D. (2007) The TARGIT Trial: Targeted Intraoperative Radiation Therapy versus Conventional Postoperative Whole-Breast Radiotherapy after Breast-Conserving Surgery for the Management of Early-Stage Invasive Breast Cancer (a Trial Update). The American Journal of Surgery, 194, 507-510.
https://doi.org/10.1016/j.amjsurg.2007.06.018

[114]   Beal, K., et al. (2007) Single-Fraction Intraoperative Radiotherapy for Breast Cancer: Early Cosmetic Results. International Journal of Radiation Oncology, Biology, Physics, 69, 19-24.
https://doi.org/10.1016/j.ijrobp.2007.02.010

[115]   Stitzenberg, K.B., et al. (2007) In Vivo Intraoperative Radiotherapy: A Novel Approach to Radiotherapy for Early Stage Breast Cancer. Annals of Surgical Oncology, 14, 1515-1516.
https://doi.org/10.1245/s10434-006-9152-3

[116]   Osti, M.F., et al. (2013) Exclusive Electron Intraoperative Radiotherapy in Early Stage Breast Cancer: A Monoinstitutional Experience. Anticancer Research, 33, 1229-1235.

[117]   Lee, K.S., et al. (2014) Metastatic Potential in MDA-MB-231 Human Breast Cancer Cells Is Inhibited by Proton Beam Irradiation via the Akt/nucLear Factor-KappaB Signaling Pathway. Molecular Medicine Reports, 10, 1007-1012.
https://doi.org/10.3892/mmr.2014.2259

[118]   Kanai, T., et al. (1980) Spot Scanning System for Proton Radiotherapy. Medical Physics, 7, 365-369.
https://doi.org/10.1118/1.594693

[119]   Wang, X., et al. (2013) Accelerated Partial-Breast Irradiation Using Intensity-Modulated Proton Radiotherapy: Do Uncertainties Outweigh Potential Benefits? The British Journal of Radiology, 86, Article ID: 20130176.
https://doi.org/10.1259/bjr.20130176

[120]   Welsh, J., et al. (2011) Intensity-Modulated Proton Therapy Further Reduces Normal Tissue Exposure during Definitive Therapy for Locally Advanced Distal Esophageal Tumors: A Dosimetric Study. International Journal of Radiation Oncology, Biology, Physics, 81, 1336-1342.
https://doi.org/10.1016/j.ijrobp.2010.07.2001

[121]   Taghian, A.G., et al. (2006) Accelerated Partial Breast Irradiation Using Proton Beams: Initial Dosimetric Experience. International Journal of Radiation Oncology, Biology, Physics, 65, 1404-1410.
https://doi.org/10.1016/j.ijrobp.2006.03.017

[122]   Kozak, K.R., et al. (2006) Dosimetric Comparison of Proton and Photon Three-Dimensional, Conformal, External Beam Accelerated Partial Breast Irradiation Techniques. International Journal of Radiation Oncology, Biology, Physics, 65, 1572-1578.
https://doi.org/10.1016/j.ijrobp.2006.04.025

[123]   Galland-Girodet, S., et al. (2014) Long-Term Cosmetic Outcomes and Toxicities of Proton Beam Therapy Compared with Photon-Based 3-Dimensional Conformal Accelerated Partial-Breast Irradiation: A Phase 1 Trial. International Journal of Radiation Oncology, Biology, Physics, 90, 493-500.
https://doi.org/10.1016/j.ijrobp.2014.04.008

[124]   Njeh, C.F., Saunders, M.W. and Langton, C.M. (2012) Accelerated Partial Breast Irradiation Using External Beam Conformal Radiation Therapy: A Review. Critical Reviews in Oncology/Hematology, 81, 1-20.
https://doi.org/10.1016/j.critrevonc.2011.01.011

[125]   Pignol, J.P., et al. (2006) First Report of a Permanent Breast 103Pd Seed Implant as Adjuvant Radiation Treatment for Early-Stage Breast Cancer. International Journal of Radiation Oncology, Biology, Physics, 64, 176-181.
https://doi.org/10.1016/j.ijrobp.2005.06.031

[126]   Keller, B.M., et al. (2012) Permanent Breast Seed Implant Dosimetry Quality Assurance. International Journal of Radiation Oncology, Biology, Physics, 83, 84-92.
https://doi.org/10.1016/j.ijrobp.2011.05.030

[127]   Orton, C.G. and Webber, B.M. (1977) Time-Dose Factor (TDF) Analysis of Dose rate Effects in Permanent Implant Dosimetry. International Journal of Radiation Oncology, Biology, Physics, 2, 55-60.
https://doi.org/10.1016/0360-3016(77)90008-6

[128]   Fentiman, I.S., et al. (1996) Inadequacy of Iridium Implant as Sole Radiation Treatment for Operable Breast Cancer. European Journal of Cancer, 32A, 608-611.
https://doi.org/10.1016/0959-8049(95)00639-7

[129]   Magee, B., et al. (1996) Prognostic Factors for Breast Recurrence after Conservative Breast Surgery and Radiotherapy: Results from a Randomised Trial. Radiotherapy & Oncology, 39, 223-227.
https://doi.org/10.1016/0167-8140(96)01747-1

[130]   Perera, F., et al. (2003) Patterns of Breast Recurrence in a Pilot Study of Brachytherapy Confined to the Lumpectomy Site for Early Breast Cancer with Six Years’ Minimum Follow-Up. International Journal of Radiation Oncology, Biology, Physics, 57, 1239-1246.
https://doi.org/10.1016/S0360-3016(03)00816-2

[131]   Shah, C., Vicini, F., Wazer, D.E., et al. (2013) The American Brachytherapy Society Consensus Statement for Accelerated Partial Breast Irradiation. Brachytherapy, 12, 267-277.
https://www.americanbrachytherapy.org/guidelines/Guidelines_Accelerated_Partial_Breast
_Irradiation.pdf


[132]   (2011) The American Society of Breast Surgeons—Consensus Statement for Accelerated Partial Breast Irradiation.
https://www.breastsurgeons.org/new_layout/about/statements/PDF_Statements/APBI.pdf

[133]   Smith, B.D., et al. (2009) Accelerated Partial Breast Irradiation Consensus Statement from the American Society for Radiation Oncology (ASTRO). Journal of the American College of Surgeons, 209, 269-277.
https://doi.org/10.1016/j.jamcollsurg.2009.02.066

[134]   Manyam, B.V., Tendulkar, R., Cherian, S., Vicini, F., Badiyan, S.N. and Shah, C. (2016) Evaluating Candidacy for Hypofractionated Radiation Therapy, Accelerated Partial Breast Irradiation, and Endocrine Therapy after Breast Conserving Surgery. American Journal of Clinical Oncology: Cancer Clinical Trials.
https://doi.org/10.1097/COC.0000000000000332

[135]   Greene, F.L., Page, D., Fleming, I., et al. (2002) The American Joint Committee on Cancer: Updating the Strategies in Cancer Staging. Bulletin of the American College of Surgeons, 87, 13-15.

[136]   Sher, D.J., et al. (2009) Partial-Breast Irradiation versus Whole-Breast Irradiation for Early-Stage Breast Cancer: A Cost-Effectiveness Analysis. International Journal of Radiation Oncology, Biology, Physics, 74, 440-446.
https://doi.org/10.1016/j.ijrobp.2008.08.015

 
 
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