Accelerated partial breast irradiation as part of breast conserving therapy of early breast carcinoma: A systematic review

New strategies for adjuvant radiotherapy of early breast cancer are being investigated in several phase III randomised trials at the present time. Accelerated partial breast irradiation (APBI) is a way to offer an early breast cancer patient, who has had breast conservative surgery, an adjuvant radiotherapy of short duration aimed at the tumour bed with a certain margin. The rationale of this strategy is that most local recurrences appear close to the tumorectomy cavity and a wish to spare the patient late radiation morbidity. This review discusses the background for APBI, the different techniques, and we highlight possible pitfalls using these techniques. A systematic overview of all phase I and 11 studies is provided. Patient selection for this therapy is pivotal and based on evidence from previous Studies on patient/tumour characteristics and pattern of local recurrences we propose inclusion criteria for patients in APBI protocols. (C) 2008 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 90 (2009) 1-13