Radiotherapy approaches for tumour bed boost in breast cancer
Authors: Tomas Kron
Institution: Peter MacCallum Cancer Centre, Melbourne, Australia
Introduction
Many clinical trials have shown that a boost of radiation to the tumour bed can improve clinical outcomes in adjuvant breast radiotherapy. However, several potential problems exist, ranging from identifying the boost volume to delivery of conformal radiotherapy.
Methods
Treatment techniques range from sequential boosts using electrons or small tangents to simultaneous infield boosts in Volumetric Modulated Arc Therapy (VMAT). The presentation will explore the benefits and drawbacks of different approaches, including the need for image guidance.
Results
As the number of fractions used for breast radiotherapy is decreasing from 25 to 15 or even 5 fractions, boost strategies are under discussion, and an ongoing UK-led clinical trial (Fast Forward Boost) is examining the inclusion of a boost in a 5-fraction schedule. While this is an attractive schedule for patients in particular if they have to travel to the radiotherapy centre, it poses challenges similar to other hypofractionated treatment regimens.
Conclusion
After securing funding, Australia will join the trial. The presentation will focus on the challenges of its technical implementation and the quality assurance to be considered.