TY - JOUR
T1 - Results of the ACCEL trial
T2 - Dosimetry in accelerated partial breast irradiation
AU - Quirk, Sarah
AU - Grendarova, Petra
AU - Craighead, Peter
AU - Phan, Tien
AU - Lesiuk, Mark
AU - Pinilla, James
AU - Liu, Hong Wei
AU - Wilson, Jane
AU - Bignell, Katelyn
AU - Austin, Tammy
AU - Olivotto, Ivo A.
AU - Roumeliotis, Michael
N1 - Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/6
Y1 - 2020/6
N2 - Purpose: To report the achieved dosimetry in the ACCEL trial and compare the results to reported dosimetry from the major accelerated partial breast irradiation (APBI) phase III trials. Methods: The ACCEL trial was a single arm, phase II, prospective cohort study. A five-field, inverse-planned, IMRT strategy was employed using a class solution technique to increase planning consistency including high dose conformity and low normal tissue dose to the ipsilateral breast. Results: Between 2016 and 2019, 283 patients were treated with 27 Gy in five fractions in consecutive days. The average PTV conformity index was 1.1. For the ipsilateral breast, the median (range) volume receiving 95% and 50% of the prescription dose was 9.7% (3.2–22.4) and 30.3% (11.1–54.6), respectively. Compared to major APBI phase III trial constraints, this reduction in irradiated volume at the 95% and 50% isodose levels represents a reduction of 209 cm3 and 265 cm3, respectively. Conclusion: The IMRT planning strategy employed in the ACCEL trial demonstrated consistent and superior dosimetry by comparison to conventionally used 3D CRT techniques. Future APBI trials should update dosimetric constraints.
AB - Purpose: To report the achieved dosimetry in the ACCEL trial and compare the results to reported dosimetry from the major accelerated partial breast irradiation (APBI) phase III trials. Methods: The ACCEL trial was a single arm, phase II, prospective cohort study. A five-field, inverse-planned, IMRT strategy was employed using a class solution technique to increase planning consistency including high dose conformity and low normal tissue dose to the ipsilateral breast. Results: Between 2016 and 2019, 283 patients were treated with 27 Gy in five fractions in consecutive days. The average PTV conformity index was 1.1. For the ipsilateral breast, the median (range) volume receiving 95% and 50% of the prescription dose was 9.7% (3.2–22.4) and 30.3% (11.1–54.6), respectively. Compared to major APBI phase III trial constraints, this reduction in irradiated volume at the 95% and 50% isodose levels represents a reduction of 209 cm3 and 265 cm3, respectively. Conclusion: The IMRT planning strategy employed in the ACCEL trial demonstrated consistent and superior dosimetry by comparison to conventionally used 3D CRT techniques. Future APBI trials should update dosimetric constraints.
KW - APBI
KW - Accelerated partial breast irradiation
KW - Class solution
KW - Dosimetry
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U2 - 10.1016/j.radonc.2020.03.004
DO - 10.1016/j.radonc.2020.03.004
M3 - Article
C2 - 32224317
AN - SCOPUS:85082192567
SN - 0167-8140
VL - 147
SP - 50
EP - 55
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
ER -