TU‐E‐500‐01: Advanced Technologies for Breast RT

Abstract

Breast conservation therapy (BCT) combining lumpectomy and post‐lumpectomy radiation therapy (RT) is a well established alternative to mastectomy for most patients with early stage breast cancer (ESBC). The fact that most of local recurrences occur in close proximity to the original tumor bed indicates that the whole breast irradiation (WBI) may not be necessary in all cases of ESBC. This led to the development of partial breast irradiation (PBI) which reduces the amount of irradiated normal tissue. Moreover, accelerated PBI can shorten the treatment time from 4–5 weeks for the current standard breast RT for ESBC to 5 days. In the current clinical practice of PBI, large CTV to PTV margins (e.g., 1.5 cm) are being used due to the variations in patient setup, anatomy change between treatment fractions, and respiratory motion during the treatment. These large margins limit the patient eligibility for PBI and lead to more normal tissue irradiated with high dose. Advanced technologies, including IMRT, IGRT, respiration motion management, and adaptive replanning, are being rapidly introduced in to the clinic to reduce these large margins and to enable conformal irradiation of either whole or partial breast. The purpose of this session is to review and update physicists on this exciting and rapidly developing area.Learning Objectives:1. Understanding rationale, indications and promise for using advanced RT Technologies for breast cancer2. Review of recent advances in imaging, planning, and delivery technologies for breast RT3. Discussing clinical implementation, and experience for using the advanced technologies for breast RT