ArticleBreast cancer (Tokyo, Japan)2026
Early outcomes of accelerated partial breast irradiation and dosimetric comparison of volumetric modulated arc therapy and three-dimensional conformal radiotherapy.
Article in Breast cancer (Tokyo, Japan), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundGuidelines 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.
methodsWe 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.
resultsAmong 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.
conclusionsAPBI 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.
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