Department of Radiation Oncology, University Hospital Erlangen, Germany.
Center of Radiotherapy, National Institute of Oncology Budapest, Hungary.
Radiother Oncol. 2018 Sep;128(3):411-420. doi: 10.1016/j.radonc.2018.04.009. Epub 2018 Apr 21.
This consensus statement from the Breast Cancer Working Group of Groupe Européen de Curiethérapie of European Society for Radiotherapy and Oncology (GEC-ESTRO) aims at generating practical guidelines for multi-catheter image-guided brachytherapy in the conservative management of breast cancer patients used for either Accelerated Partial Breast Irradiation (APBI) or for a breast boost.
Recent advances in techniques of multi-catheter brachytherapy were summarized and all the relevant literature was reviewed by a panel of experts. Panel members of the GEC-ESTRO experts participated in a series of conferences, supplemented their clinical experience, were surveyed to determine their current practices and patterns, performed a literature review, and formulated recommendations for implementing APBI with multi-catheter brachytherapy, focusing on treatment planning issues, catheter insertion, dosimetry and quality assurance. This document was reviewed and approved by the full panel, the GEC-ESTRO executive board and by the ACROP (Advisory Committee on Radiation Oncology Practice).
Three-dimensional (3D) treatment planning, catheter insertion techniques, dosimetry and methods of quality assurance for APBI and boost with multi-catheter image-guided brachytherapy after breast conserving surgery are described. Detailed recommendations for daily practice including dose constraints are given.
Recent standards and guidelines for the use of APBI with different multi-catheter image-guided brachytherapy techniques have been defined. Different techniques are used to insert the catheters. Guidelines are mandatory to assure precise catheter insertion for coverage of the target volume and to guarantee high-quality dosimetry. The same rules apply for brachytherapy based boost irradiation for breast cancer after whole breast irradiation as well as for partial breast re-irradiation.
这份来自欧洲放射肿瘤学会（ESTRO）的欧洲近距离放射治疗协作组（GEC-ESTRO）乳腺癌工作组的共识声明旨在为多导管图像引导下的乳腺癌保乳患者近距离放射治疗提供实用指南，包括加速部分乳腺照射（APBI）或乳房局部加量照射。
总结了多导管近距离放射治疗技术的最新进展，由专家组对所有相关文献进行了综述。GEC-ESTRO 专家组成员参加了一系列会议，结合他们的临床经验，对当前的实践和模式进行了调查，进行了文献回顾，并制定了使用多导管近距离放射治疗实施 APBI 的建议，重点关注治疗计划问题、导管插入、剂量学和质量保证。本文件经全体专家组、GEC-ESTRO 执行委员会和 ACROP（放射肿瘤实践咨询委员会）审议和批准。
描述了保乳手术后多导管图像引导下的三维（3D）治疗计划、导管插入技术、剂量学和质量保证方法，适用于 APBI 和局部加量照射。给出了详细的日常实践建议，包括剂量限制。
已经为不同的多导管图像引导下近距离放射治疗技术的 APBI 使用定义了最新的标准和指南。不同的技术用于插入导管。指南对于确保准确地覆盖靶区的导管插入和保证高质量的剂量学是强制性的。同样的规则适用于全乳照射后乳腺癌的基于近距离放射治疗的局部加量照射，以及部分乳房再照射。
