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Background <p>Guidelines for partial breast irradiation as postoperative radiotherapy following breast-conserving therapy for breast cancer have been published; consequently, the National Comprehensive Cancer Network guidelines now designate accelerated partial breast irradiation (APBI) as a standard treatment option for these patients. APBI was introduced at our institution in July 2024. Here, we report the early clinical outcomes of the use of APBI and present a dosimetric comparison of volumetric modulated arc therapy (VMAT) and three-dimensional conformal radiotherapy (3D-CRT) in delivering APBI.</p> Methods <p>We performed a retrospective review of the charts of patients who underwent breast-conserving surgery followed by radiotherapy between July 2024 and May 2025. APBI was performed according to the ASTRO guidelines; specifically, 30&#xa0;Gy was administered in 5 fractions every other day. Among patients receiving APBI, dosimetric parameters were compared between 3D-CRT and VMAT. Acute adverse events occurring within 28&#xa0;days of treatment initiation were evaluated using the Common Terminology Criteria for Adverse Events, Version 5.0.</p> Results <p>Among the 268 patients, 109 were deemed suitable for APBI. Of these, 27 (25%) chose to undergo whole-breast irradiation, while 82 (75%) chose APBI. The median age in the APBI group was 56&#xa0;years (range, 43–78). The pathologic tumor size was 2&#xa0;cm or smaller in 63 patients and greater than 2&#xa0;cm in 19 patients. Dosimetric parameter analysis revealed the superiority of VMAT over 3D-CRT in terms of target coverage and normal tissue sparing. Acute adverse events included grade 1 dermatitis in 65 (79%) patients and grade 1 breast pain in 4 (5%) patients; no grade 2 or worse events were reported.</p> Conclusions <p>APBI with VMAT was completed without inducing severe acute toxicity in all the patients in this real-world setting. Long-term follow-up is needed to evaluate oncological outcomes and late toxicity.</p>

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Early outcomes of accelerated partial breast irradiation and dosimetric comparison of volumetric modulated arc therapy and three-dimensional conformal radiotherapy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月16日

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  • Tomomi Aoshika,
  • Nobue Uchida,
  • Fumihiro Tomita,
  • Ryohei Yamauchi,
  • Reiko Kondo,
  • Ayako Kurose,
  • Junko Takei,
  • Atsushi Yoshida,
  • Satoshi Ishikura

摘要

Background

Guidelines for partial breast irradiation as postoperative radiotherapy following breast-conserving therapy for breast cancer have been published; consequently, the National Comprehensive Cancer Network guidelines now designate accelerated partial breast irradiation (APBI) as a standard treatment option for these patients. APBI was introduced at our institution in July 2024. Here, we report the early clinical outcomes of the use of APBI and present a dosimetric comparison of volumetric modulated arc therapy (VMAT) and three-dimensional conformal radiotherapy (3D-CRT) in delivering APBI.

Methods

We performed a retrospective review of the charts of patients who underwent breast-conserving surgery followed by radiotherapy between July 2024 and May 2025. APBI was performed according to the ASTRO guidelines; specifically, 30 Gy was administered in 5 fractions every other day. Among patients receiving APBI, dosimetric parameters were compared between 3D-CRT and VMAT. Acute adverse events occurring within 28 days of treatment initiation were evaluated using the Common Terminology Criteria for Adverse Events, Version 5.0.

Results

Among the 268 patients, 109 were deemed suitable for APBI. Of these, 27 (25%) chose to undergo whole-breast irradiation, while 82 (75%) chose APBI. The median age in the APBI group was 56 years (range, 43–78). The pathologic tumor size was 2 cm or smaller in 63 patients and greater than 2 cm in 19 patients. Dosimetric parameter analysis revealed the superiority of VMAT over 3D-CRT in terms of target coverage and normal tissue sparing. Acute adverse events included grade 1 dermatitis in 65 (79%) patients and grade 1 breast pain in 4 (5%) patients; no grade 2 or worse events were reported.

Conclusions

APBI with VMAT was completed without inducing severe acute toxicity in all the patients in this real-world setting. Long-term follow-up is needed to evaluate oncological outcomes and late toxicity.