Smith Benjamin D, Arthur Douglas W, Buchholz Thomas A, Haffty Bruce G, Hahn Carol A, Hardenbergh Patricia H, Julian Thomas B, Marks Lawrence B, Todor Dorin A, Vicini Frank A, Whelan Timothy J, White Julia, Wo Jennifer Y, Harris Jay R
Radiation Oncology Flight, Wilford Hall Medical Center, Lackland AFB, TX, USA.
Int J Radiat Oncol Biol Phys. 2009 Jul 15;74(4):987-1001. doi: 10.1016/j.ijrobp.2009.02.031.
To present guidance for patients and physicians regarding the use of accelerated partial-breast irradiation (APBI), based on current published evidence complemented by expert opinion.
A systematic search of the National Library of Medicine's PubMed database yielded 645 candidate original research articles potentially applicable to APBI. Of these, 4 randomized trials and 38 prospective single-arm studies were identified. A Task Force composed of all authors synthesized the published evidence and, through a series of meetings, reached consensus regarding the recommendations contained herein.
The Task Force proposed three patient groups: (1) a "suitable" group, for whom APBI outside of a clinical trial is acceptable, (2) a "cautionary" group, for whom caution and concern should be applied when considering APBI outside of a clinical trial, and (3) an "unsuitable" group, for whom APBI outside of a clinical trial is not generally considered warranted. Patients who choose treatment with APBI should be informed that whole-breast irradiation (WBI) is an established treatment with a much longer track record that has documented long-term effectiveness and safety.
Accelerated partial-breast irradiation is a new technology that may ultimately demonstrate long-term effectiveness and safety comparable to that of WBI for selected patients with early breast cancer. This consensus statement is intended to provide guidance regarding the use of APBI outside of a clinical trial and to serve as a framework to promote additional clinical investigations into the optimal role of APBI in the treatment of breast cancer.
基于当前已发表的证据并辅以专家意见，为患者和医生提供关于加速部分乳腺照射（APBI）使用的指导。
对美国国立医学图书馆的PubMed数据库进行系统检索，得到645篇可能适用于APBI的候选原始研究文章。其中，确定了4项随机试验和38项前瞻性单臂研究。由所有作者组成的特别工作组综合了已发表的证据，并通过一系列会议就本文所含建议达成共识。
特别工作组提出了三类患者群体：（1）“合适”群体，对于他们而言，临床试验之外的APBI是可接受的；（2）“谨慎”群体，对于他们而言，在考虑临床试验之外的APBI时应谨慎并予以关注；（3）“不合适”群体，对于他们而言，一般不认为临床试验之外的APBI是必要的。选择接受APBI治疗的患者应被告知，全乳照射（WBI）是一种既定的治疗方法，其记录的长期有效性和安全性的历史更为悠久。
加速部分乳腺照射是一项新技术，对于某些早期乳腺癌患者，它最终可能证明其长期有效性和安全性与全乳照射相当。本共识声明旨在为临床试验之外APBI的使用提供指导，并作为一个框架，以促进对APBI在乳腺癌治疗中最佳作用的更多临床研究。
