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• W4280583409 abstract "First, we agree with the GEC-ESTRO group that, at the inception of this phase 1 trial, intraoperative radiation (IORT) was not felt to be an ideal form of APBI, given the increased rates of local recurrence reported by the ELIOT 1 Veronesi U Orecchia R Maisonneuve P et al. Intraoperative radiotherapy versus external radiotherapy for early breast cancer (ELIOT): A randomised controlled equivalence trial. Lancet Oncol. 2013; 14: 1269-1277 Abstract Full Text Full Text PDF PubMed Scopus (547) Google Scholar and TARGIT-A trials 3 Vaidya JS Wenz F Bulsara M et al. Risk-adapted targeted intraoperative radiotherapy versus whole-breast radiotherapy for breast cancer: 5-year results for local control and overall survival from the TARGIT-A randomised trial. Lancet. 2014; 383: 603-613 Abstract Full Text Full Text PDF PubMed Scopus (612) Google Scholar at that time. However, recently, with long-term follow-up of the TARGIT-A trial, the investigators have reported evidence of noninferiority between the TARGIT-IORT modality and whole breast radiation in properly selected patients. 4 Vaidya JS Bulsara M Baum M et al. Long term survival and local control outcomes from single dose targeted intraoperative radiotherapy during lumpectomy (TARGIT-IORT) for early breast cancer: TARGIT-A randomised clinical trial. BMJ. 2020; 370: m2836 Crossref PubMed Scopus (77) Google Scholar Still, as Hannoun-Levi et al point out, about 20% of patients receiving TARGIT-IORT still required adjuvant external beam radiation, given adverse pathologic features found after surgical pathology was finalized, which is not ideal. This, therefore, spurred our interest to investigate neo-adjuvant single-fraction approaches with longer intervals before surgery, allowing radiation related tissue changes to affect pathology findings that might better inform the need for subsequent external beam radiation therapy. Furthermore, we recognize that local recurrences for hormone positive cancers typically can occur after 5 years, making it difficult to make definitive recommendations with limited follow up, as in the multicatheter interstitial brachytherapy (MCIB) approach reported by Hannoun-Levi and colleagues. 5 Hannoun-Lévi JM Lam Cham Kee D Gal J et al. Accelerated partial breast irradiation in the elderly: 5-Year results of the single fraction elderly breast irradiation (SiFEBI) phase I/II trial. Brachytherapy. 2020; 19: 90-96 Abstract Full Text Full Text PDF PubMed Scopus (23) Google Scholar Like the MCIB technique, S-PBI, as investigated in this trial, is another promising adjuvant modality for single-episode treatment APBI and one that will improve access to care, particularly for patients at centers where interstitial brachytherapy is not available." @default.
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• W4280583409 date "2022-06-01" @default.
• W4280583409 modified "2023-10-03" @default.
• W4280583409 title "In Reply to Hannoun-Levi et al." @default.
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• W4280583409 doi "https://doi.org/10.1016/j.ijrobp.2022.02.034" @default.
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