Patient selection for accelerated partial-breast irradiation (APBI) after breast-conserving surgery: Recommendations of the Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) breast cancer working group based on clinical evidence (2009)

Review of clinical brachytherapy uncertainties: analysis guidelines of GEC-ESTRO and the AAPM

Dosimetric comparison of four different external beam partial breast irradiation techniques: Three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, helical tomotherapy, and proton beam therapy

In vivo dosimetry in brachytherapy: Requirements and future directions for research, development, and clinical practice.

PURPOSE/OBJECTIVES Three-dimensional (3D) printing is recognized as an effective clinical and educational tool in procedurally intensive specialties. However, it has a nascent role in radiation oncology. The goal of this investigation is to clarify the extent to which 3D printing applications are currently being used in radiation oncology through a systematic review of the literature. MATERIALS/METHODS A search protocol was defined according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Included articles were evaluated using parameters of interest including: year and country of publication, experimental design, sample size for clinical studies, radiation oncology topic, reported outcomes, and implementation barriers or safety concerns. RESULTS One hundred and three publications from 2012 to 2019 met inclusion criteria. The most commonly described 3D printing applications included quality assurance phantoms (26%), brachytherapy applicators (20%), bolus (17%), preclinical animal irradiation (10%), compensators (7%), and immobilization devices (5%). Most studies were preclinical feasibility studies (63%), with few clinical investigations such as case reports or series (13%) or cohort studies (11%). The most common applications evaluated within clinical settings included brachytherapy applicators (44%) and bolus (28%). Sample sizes for clinical investigations were small (median 10, range 1-42). A minority of articles described basic or translational research (11%) and workflow or cost evaluation studies (3%). The number of articles increased over time (P < 0.0001). While outcomes were heterogeneous, most studies reported successful implementation of accurate and cost-effective 3D printing methods. CONCLUSIONS Three-dimensional printing is rapidly growing in radiation oncology and has been implemented effectively in a diverse array of applications. Although the number of 3D printing publications has steadily risen, the majority of current reports are preclinical in nature and the few clinical studies that do exist report on small sample sizes. Further dissemination of ongoing investigations describing the clinical application of developed 3D printing technologies in larger cohorts is warranted.

https://aapm.onlinelibrary.wiley.com/doi/pdf/10.1002/acm2.12907

Three-dimensional printing in radiation oncology: A systematic review of the literature

Computed tomography for excision cavity localization and 3D-treatment planning in partial breast irradiation with high-dose-rate interstitial brachytherapy.

Individualized 3D-printed templates for high-dose-rate interstitial multicathether brachytherapy in patients with breast cancer.

Aim To investigate, in a phase II prospective study, the efficacy of partial breast irradiation administered with high-dose-rate brachytherapy. Methods After conservative surgery 80 patients with low-risk early-stage breast cancer received 4Gy twice a day for 4days (total dose 32Gy). Catheter implantation was performed during surgery in 15 cases and postoperatively, at a median of 8weeks from surgery, in 65 patients. Adjuvant therapy was chemotherapy (8) and/or hormone therapy (61). Results Cosmetic results were good/excellent in 79 patients. Perioperative toxicity was very low. Acute skin toxicity developed in seven cases (six G1; one G2); late G3 cutaneous toxicity in one patient and late subcutaneous toxicity in five (three G1; two G2). Grade 1 teleangiectasia occurred in eight patients and grade 2 in one. Fat necrosis was symptomatic in one patient and asymptomatic in five. Only one patient presented pain after brachytherapy. A significantly ( p =0.001) higher frequency of late toxicity was observed in patients implanted during surgery, the group, which included the only patient with a fair cosmetic result. No local or regional relapses have occurred to date. The median follow-up was 30months (range 3–52). Conclusion This strategy is a viable option in selected patients with early-stage breast cancer as it is feasible, reproducible and associated with very low perioperative and acute toxicity. The low incidence of late side effects will probably change as follow-up lengthens.

Partial breast irradiation with interstitial high-dose-rate brachytherapy in early breast cancer: Results of a phase II prospective study

EP-1527: Pelvic Intensity-Modulated Radiotherapy in prone and supine position in gynaecological cancer

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Computed tomography for excision cavity localization and 3D-treatment planning in partial breast irradiation with high-dose-rate interstitial brachytherapy.

Individualized 3D-printed templates for high-dose-rate interstitial multicathether brachytherapy in patients with breast cancer.

Partial breast irradiation with interstitial high-dose-rate brachytherapy in early breast cancer: Results of a phase II prospective study

EP-1527: Pelvic Intensity-Modulated Radiotherapy in prone and supine position in gynaecological cancer