open access

Vol 24, No 2 (2019)
Reviews
Published online: 2019-03-01
Submitted: 2018-08-01
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Effectiveness of different accelerated partial breast irradiation techniques for the treatment of breast cancer patients: Systematic review using indirect comparisons of randomized clinical trials

Gustavo Nader Marta, Jessica Barrett, Gustavo José Porfirio, Ana Luiza Martimbianco, José Luiz Bevilacqua, Philip Poortmans, Rachel Riera
DOI: 10.1016/j.rpor.2019.01.009
·
Rep Pract Oncol Radiother 2019;24(2):165-174.

open access

Vol 24, No 2 (2019)
Reviews
Published online: 2019-03-01
Submitted: 2018-08-01

Abstract

Aim

This systematic review was conducted to compare the effectiveness of different accelerated partial breast irradiation (APBI) techniques for the treatment of breast cancer patients.

Background

Numerous (APBI) techniques are available for clinical practice.

Methods and materials

Systematic review of randomized controlled trials of APBI versus whole breast irradiation (WBI). The data from APBI studies were extracted for the analyses. Indirect comparisons were used to compare different APBI techniques.

Results

Ten studies fulfilled the inclusion criteria. A total of 4343 patients were included, most of them with tumor stage T1-T2 and N0. Regarding APBI techniques, six trials used external beam radiation therapy; one intraoperative electrons; one intraoperative low-energy photons; one brachytherapy; and one external beam radiation therapy or brachytherapy. The indirect comparisons related to 5-years local control and 5-years overall survival were not significantly different between APBI techniques.

Conclusions

Based on indirect comparisons, no differences in clinical outcomes were observed among diverse APBI techniques in published clinical trials that formally compared WBI to APBI. However wide confidence intervals and high risk of inconsistency precluded a sound conclusion. Further head-to-head clinical trials comparing different APBI techniques are required to confirm our findings. Studies comparing different techniques using individual participant data and/or real-life data from population-based studies/registries could also provide more robust results.

Abstract

Aim

This systematic review was conducted to compare the effectiveness of different accelerated partial breast irradiation (APBI) techniques for the treatment of breast cancer patients.

Background

Numerous (APBI) techniques are available for clinical practice.

Methods and materials

Systematic review of randomized controlled trials of APBI versus whole breast irradiation (WBI). The data from APBI studies were extracted for the analyses. Indirect comparisons were used to compare different APBI techniques.

Results

Ten studies fulfilled the inclusion criteria. A total of 4343 patients were included, most of them with tumor stage T1-T2 and N0. Regarding APBI techniques, six trials used external beam radiation therapy; one intraoperative electrons; one intraoperative low-energy photons; one brachytherapy; and one external beam radiation therapy or brachytherapy. The indirect comparisons related to 5-years local control and 5-years overall survival were not significantly different between APBI techniques.

Conclusions

Based on indirect comparisons, no differences in clinical outcomes were observed among diverse APBI techniques in published clinical trials that formally compared WBI to APBI. However wide confidence intervals and high risk of inconsistency precluded a sound conclusion. Further head-to-head clinical trials comparing different APBI techniques are required to confirm our findings. Studies comparing different techniques using individual participant data and/or real-life data from population-based studies/registries could also provide more robust results.

Get Citation

Keywords

Breast cancer; Breast-conserving therapy; Radiation therapy; Accelerated partial breast irradiation; APBI

About this article
Title

Effectiveness of different accelerated partial breast irradiation techniques for the treatment of breast cancer patients: Systematic review using indirect comparisons of randomized clinical trials

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 24, No 2 (2019)

Pages

165-174

Published online

2019-03-01

DOI

10.1016/j.rpor.2019.01.009

Bibliographic record

Rep Pract Oncol Radiother 2019;24(2):165-174.

Keywords

Breast cancer
Breast-conserving therapy
Radiation therapy
Accelerated partial breast irradiation
APBI

Authors

Gustavo Nader Marta
Jessica Barrett
Gustavo José Porfirio
Ana Luiza Martimbianco
José Luiz Bevilacqua
Philip Poortmans
Rachel Riera

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