Insight

Todd Scarbrough: Are ASTRO’s radonc partial breast RT guidelines and current NCCN partial breast RT guidelines at odds for breast cancer treatment?

Photo of Todd Scarbrough taken from alcancercare.com

Dec 17, 2023, 18:02

Todd Scarbrough: Are ASTRO’s radonc partial breast RT guidelines and current NCCN partial breast RT guidelines at odds for breast cancer treatment?

Todd Scarbrough, Radiation Oncologist at Northeast Alabama Regional Medical Center, shared on X:

“Are ASTRO’s radonc partial breast RT guidelines and current NCCN partial breast RT guidelines at odds for breast cancer treatment?

Of course the answer is yes… at least re: BID treatment fractionation regimens

(read on…)

Todd Scarbrough: Are ASTRO's radonc partial breast RT guidelines and current NCCN partial breast RT guidelines at odds for breast cancer treatment?

The NCCN says 38.5 Gy/10 fx in one week is an acceptable dosing regimen:

Todd Scarbrough: Are ASTRO's radonc partial breast RT guidelines and current NCCN partial breast RT guidelines at odds for breast cancer treatment?

But ASTRO says 38.5 Gy/10 fx “is not recommended, based on poorer cosmetic outcomes” (recommendation: STRONG, quality of evidence: MODERATE)

Todd Scarbrough: Are ASTRO's radonc partial breast RT guidelines and current NCCN partial breast RT guidelines at odds for breast cancer treatment?

It’s interesting that 3 of the authors of the ASTRO partial breast guideline are on the NCCN committee (just trying to nonplus Jeff Ryckman with this one) Lyons, Anderson and Pierce “self-disagreeing” in essence. (See here)

Todd Scarbrough: Are ASTRO's radonc partial breast RT guidelines and current NCCN partial breast RT guidelines at odds for breast cancer treatment?

Maybe I should not be bothered that the QC seems low here… and I mean specifically the low QC at the NCCN because I agree with ASTRO guidelines: 38.5Gy/10fx should never be used for PBI esp given current alternatives of 30 or 26 Gy in 5 fx PBI, or TARGIT.”

For the article click here.
Source: Todd Scarbrough/X