Ultrashort courses of adjuvant breast radiotherapy: Wave of the future or a fool's errand?

Atif J. Khan, Roger G. Dale, Douglas W. Arthur, Bruce G. Haffty, Dorin A. Todor, Frank A. Vicini

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations

Abstract

In accelerated partial breast irradiation (APBI), the most commonly used fractionation schemes include 340 or 385 centigrays delivered in a twice daily administration. A further progression of the APBI literature has been the recent interest in extremely short courses of adjuvant radiotherapy, usually delivered by intraoperative radiotherapy techniques. This newer area of single-fraction radiotherapy approaches remains highly contentious. In particular, the recently reported TARGIT trial has been the subject of both praise and scorn, and a critical examination of the trial data and the underlying hypotheses is warranted. Short-term outcomes of the related Italian ELIOT approach have also been reported. Although the assumptions of linear quadratic formalism are likely to hold true in the range of 2 to 8 grays, equating different schedules beyond this range is problematic. A major problem of current single-fraction approaches is that the treatment doses are chosen empirically, or are based on tolerability, or on the physical dose delivery characteristics of the chosen technology rather than radiobiological rationale. This review article summarizes the current data on ultrashort courses of adjuvant breast radiotherapy and highlights both the promise and the potential pitfalls of the abbreviated treatment.

Original languageEnglish (US)
Pages (from-to)1962-1970
Number of pages9
JournalCancer
Volume118
Issue number8
DOIs
StatePublished - Apr 15 2012

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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