LONDON, Ontario - The American Society for Radiation Oncology (ASTRO) has published a consensus statement outlining patient selection criteria and best practices for the use of accelerated partial-breast irradiation (APBI) in the July 15 issue of the International Journal of Radiation Oncology Biology Physics. The report is based on a systematic search of the National Library of Medicine's 645 original research articles, including research conducted in London over a decade ago that allows specific women to complete treatment for breast cancer in one week instead of five weeks.
Researchers at Lawson Health Research Institute located at the London Health Sciences Centre's London Regional Cancer Program have pioneered research into breast cancer treatment that allows preservation of the breast with radiation delivered in just five treatment days. London was one of the first to publish data of the use of APBI using brachytherapy catheters in the early 1990's.
For decades, whole-breast irradiation, where radiation is delivered to the entire breast five days a week for five to six weeks, has been the standard treatment for patients with early breast cancer treated with breast conserving surgery. Whole-breast irradiation has been shown to reduce the risk of recurrence in the affected breast and increase the likelihood of long-term survival. However, recently there has been growing interest in using APBI, where radiation is used to treat only a part of the breast affected by cancer and the treatment time is decreased from several weeks to four or five days.
The ASTRO consensus statement explains which patients may be considered for APBI, what constitutes proper informed consent for patients treated with APBI, which diagnostic imaging tests are needed for patients treated with APBI, how to integrate APBI with surgical and chemotherapy treatment and how the various techniques for APBI compare to one another.
APRI has several benefits, including decreased overall treatment time and a decrease in the radiation delivered to healthy tissue and surrounding organs, but its long-term safety and effectiveness, compared to whole-breast irradiation, are not yet known.
London continues to lead the way in investigating the APBI application to more women. Currently, Dr. David D'Souza, Radiation Oncologist at London Health Sciences Centre and Assistant Professor, Department of Oncology, Schulich School of Medicine & Dentistry at The University of Western Ontario is the principal site investigator of a study being performed across North America. The study is investigating over 4000 women who will undergo this partial-breast radiation technique and involves some of the leading centres and physicians in the world.
London is also participating in a Canadian-led initiative called RAPID (Randomized Trial of Accelerated Partial Breast Irradiation) that is investigating if APBI is as effective as whole-breast irradiation following breast conserving surgery in women. Collectively, more than 100 women have been enrolled in these studies through the London Regional Cancer Program.
Dr. Michael Lock, Medical Director of the Radiation Treatment Program at London Health Sciences Centre says that without Dr. D'Souza and the team of researchers bringing these studies to London, women in Southwestern Ontario may not have had access to this treatment option.
"We are very excited about the possibility of offering a more convenient and beneficial way of treating breast cancer patients, which will allow women to spend less time away from work and their families to get the treatment that they need," says Dr. D'Souza. "I hope that our continued research will allow us to expand the use of this treatment to many more patients in the future."
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About Lawson Health Research Institute As the research institute of London Health Sciences Centre and St. Joseph's Health Care, London, and working in partnership with The University of Western Ontario, Lawson Health Research Institute is committed to furthering scientific knowledge to advance health care around the world.
