Patient selection for accelerated partial-breast irradiation (APBI) after breast-conserving surgery: Recommendations of the Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) breast cancer working group based on clinical evidence (2009)

C. Polgár, Erik Van Limbergen, Richard Pötter, György Kovács, Alfredo Polo, Jaroslaw Lyczek, Guido Hildebrandt, Peter Niehoff, Jose Luis Guinot, Ferran Guedea, Bengt Johansson, Oliver J. Ott, T. Major, Vratislav Strnad

Research output: Contribution to journalArticle

366 Citations (Scopus)

Abstract

Purpose: To give recommendations on patient selection criteria for the use of accelerated partial-breast irradiation (APBI) based on available clinical evidence complemented by expert opinion. Methods and materials: Overall, 340 articles were identified by a systematic search of the PubMed database using the keywords "partial-breast irradiation" and "APBI". This search was complemented by searches of reference lists of articles and handsearching of relevant conference abstracts and book chapters. Of these, 3 randomized and 19 prospective non-randomized studies with a minimum median follow-up time of 4 years were identified. The authors reviewed the published clinical evidence on APBI, complemented by relevant clinical and pathological studies of standard breast-conserving therapy and, through a series of personal communications, formulated the recommendations presented in this article. Results: The GEC-ESTRO Breast Cancer Working Group recommends three categories guiding patient selection for APBI: (1) a low-risk group for whom APBI outside the context of a clinical trial is an acceptable treatment option; including patients ageing at least 50 years with unicentric, unifocal, pT1-2 (≤30 mm) pN0, non-lobular invasive breast cancer without the presence of an extensive intraductal component (EIC) and lympho-vascular invasion (LVI) and with negative surgical margins of at least 2 mm, (2) a high-risk group, for whom APBI is considered contraindicated; including patients ageing ≤40 years; having positive margins, and/or multicentric or large (>30 mm) tumours, and/or EIC positive or LVI positive tumours, and/or 4 or more positive lymph nodes or unknown axillary status (pNx), and (3) an intermediate-risk group, for whom APBI is considered acceptable only in the context of prospective clinical trials. Conclusions: These recommendations will provide a clinical guidance regarding the use of APBI outside the context of a clinical trial before large-scale randomized clinical trial outcome data become available. Furthermore they should promote further clinical research focusing on controversial issues in the treatment of early-stage breast carcinoma.

Original languageEnglish
Pages (from-to)264-273
Number of pages10
JournalRadiotherapy and Oncology
Volume94
Issue number3
DOIs
Publication statusPublished - Mar 2010

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Radiation Oncology
Segmental Mastectomy
Patient Selection
Breast
Breast Neoplasms
Clinical Trials
Blood Vessels
Expert Testimony
PubMed
Neoplasms
Therapeutics
Randomized Controlled Trials
Lymph Nodes
Communication
Databases

Keywords

  • Accelerated partial breast irradiation
  • Brachytherapy
  • Patient selection
  • Systematic review

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology

Cite this

Patient selection for accelerated partial-breast irradiation (APBI) after breast-conserving surgery : Recommendations of the Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) breast cancer working group based on clinical evidence (2009). / Polgár, C.; Limbergen, Erik Van; Pötter, Richard; Kovács, György; Polo, Alfredo; Lyczek, Jaroslaw; Hildebrandt, Guido; Niehoff, Peter; Guinot, Jose Luis; Guedea, Ferran; Johansson, Bengt; Ott, Oliver J.; Major, T.; Strnad, Vratislav.

In: Radiotherapy and Oncology, Vol. 94, No. 3, 03.2010, p. 264-273.

Research output: Contribution to journalArticle

Polgár, C. ; Limbergen, Erik Van ; Pötter, Richard ; Kovács, György ; Polo, Alfredo ; Lyczek, Jaroslaw ; Hildebrandt, Guido ; Niehoff, Peter ; Guinot, Jose Luis ; Guedea, Ferran ; Johansson, Bengt ; Ott, Oliver J. ; Major, T. ; Strnad, Vratislav. / Patient selection for accelerated partial-breast irradiation (APBI) after breast-conserving surgery : Recommendations of the Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) breast cancer working group based on clinical evidence (2009). In: Radiotherapy and Oncology. 2010 ; Vol. 94, No. 3. pp. 264-273.
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AU - Limbergen, Erik Van

AU - Pötter, Richard

AU - Kovács, György

AU - Polo, Alfredo

AU - Lyczek, Jaroslaw

AU - Hildebrandt, Guido

AU - Niehoff, Peter

AU - Guinot, Jose Luis

AU - Guedea, Ferran

AU - Johansson, Bengt

AU - Ott, Oliver J.

AU - Major, T.

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