Pérez-Echagüen Susana, Sanz-Freire Camilo José, Guinot-Rodríguez José Luis, Gutiérrez-Miguélez Cristina, Samper-Ots Pilar, González-Pérez Víctor, Villafranca-Iturre Elena, Modolell Ignasi, Pellejero-Pellejero Santiago, Cambeiro-Vázquez Mauricio, Ossola-Lentati Gustavo
Radiation Oncology Department, CIBIR - Complejo Hospitalario San Pedro La Rioja, Piqueras 98, E-26006 Logroño, Spain.
Medical Physics Department, CIBIR - Complejo Hospitalario San Pedro La Rioja, Piqueras 98, E-26006 Logroño, Spain.
Rep Pract Oncol Radiother. 2020 Sep-Oct;25(5):832-839. doi: 10.1016/j.rpor.2020.05.004. Epub 2020 Jul 25.
To establish consensus guidelines for a safe clinical practice of accelerated partial breast irradiation (APBI) interstitial multicatheter brachytherapy (BT).
APBI with interstitial multicatheter BT has proved to be effective in the treatment of early stage breast cancer. This paradigm shift in the approach to early breast cancer conservative treatment, along with the existing controversies on the clinical practice of APBI, prompted the Spanish Brachytherapy Group (GEB) of the Spanish Societies of Radiation Oncology (SEOR) and Medical Physics (SEFM) to address BT APBI in a consensus meeting.
Prior to the meeting, a survey with 27 questions on indication, inclusion criteria, BT modality, implant technique, image guidance and simulation, CTV and OAR definition, dose prescription and fractionation, dose calculation, implant quality metrics and OAR dose constrains was distributed. Items not reaching a level of agreement of 70% were discussed and voted during the meeting.
26 Institutions completed the survey, 60% of them perform APBI procedures. The analysis of the survey showed consensus reached on approximately half the questions. An expert panel discussed the remaining items; thereafter, a voting established the definite consensus.
This document summarizes the consensus guidelines agreed during the meeting of the Spanish Brachytherapy Group SEOR-SEFM. Institutions with BT facilities available should offer interstitial BT APBI as a treatment option to patients fulfilling the inclusion criteria. Institutions willing to implement interstitial BT APBI are encouraged to follow the consensus guidelines established herein.
制定加速部分乳腺照射（APBI）组织间多导管近距离放疗（BT）安全临床实践的共识指南。
组织间多导管BT的APBI已被证明在早期乳腺癌治疗中有效。早期乳腺癌保守治疗方法的这种范式转变，以及APBI临床实践中存在的争议，促使西班牙放射肿瘤学会（SEOR）和医学物理学会（SEFM）的西班牙近距离放疗组（GEB）在一次共识会议上讨论BT APBI。
会议前，分发了一份包含27个问题的调查问卷，内容涉及适应症、纳入标准、BT方式、植入技术、图像引导与模拟、临床靶区（CTV）和危及器官（OAR）定义、剂量处方与分割、剂量计算、植入质量指标和OAR剂量限制。未达到70%一致同意水平的项目在会议期间进行了讨论和投票。
26家机构完成了调查，其中60%开展APBI程序。调查分析显示，约一半的问题达成了共识。一个专家小组讨论了其余项目；此后，通过投票达成了最终共识。
本文档总结了西班牙近距离放疗组SEOR-SEFM会议期间达成的共识指南。具备BT设施的机构应为符合纳入标准的患者提供组织间BT APBI作为一种治疗选择。鼓励愿意实施组织间BT APBI的机构遵循本文制定的共识指南。
