• Alphonse G Taghian, Kevin R Kozak, Karen P Doppke, Angela Katz, Barbara L Smith, Michele Gadd, Michelle Specht, Kevin Hughes, Kristina Braaten, Lisa A Kachnic, Abram Recht, and Simon N Powell.
• Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA 02114, USA. ataghian@partners.org
• Int. J. Radiat. Oncol. Biol. Phys. 2006 Mar 15; 64 (4): 1092-9.

PurposeSeveral accelerated partial-breast irradiation (APBI) techniques are being investigated in patients with early-stage breast cancer. We present our initial experience using three-dimensional conformal radiation therapy (3D-CRT).Methods And MaterialsSixty-one patients with tumors of 2 cm or less and negative axillary nodes were treated with 3D-CRT accelerated partial-breast irradiation (APBI) between August 2003 and March 2005. The prescribed radiation dose was 32 Gy in 4-Gy fractions given twice daily. Efforts were made to minimize the number of beams required to achieve adequate planning target volume (PTV) coverage.ResultsA combination of photons and electrons was used in 85% of patients. A three-field technique that consisted of opposed, conformal tangential photons and enface electrons was employed in 43 patients (70%). Nine patients (15%) were treated with a four-field arrangement, which consisted of three photon fields and enface electrons. Mean PTV volumes that received 100%, 95%, and 90% of the prescribed dose were 93% +/- 7%, 97% +/- 4%, and 98% +/- 2%, respectively. Dose inhomogeneity exceeded 10% in only 7 patients (11%). Mean doses to the ipsilateral lung and heart were 1.8 Gy and 0.8 Gy, respectively.ConclusionsSimple 3D-CRT techniques of APBI can achieve appropriate PTV coverage while offering significant normal-tissue sparing. Therefore, this noninvasive approach may increase the availability of APBI to patients with early-stage breast cancer.

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