Preferred Techniques for Treatment Planning

Treatment plans should be individualized after consideration of many factors, including tumor characteristics, patient anatomy and comorbidities.


Three-dimensional conformal (3-D CRT) treatment planning with a forward planned, field-in-field technique is recommended to achieve homogenous radiation dosing and full coverage of the tumor bed.

Approaches that incorporate deep inspiration breath hold, target and organ-at-risk contouring and optimal patient positioning are recommended to minimize the radiation dose affecting nearby organs and normal tissue, including the heart, lungs and opposite breast.

The guideline was based on a systematic literature review of studies published from January 2009 through January 2016. A total of 528 abstracts were retrieved from PubMed, and the 100 articles that met inclusion criteria were evaluated by a 15-member task force of radiation oncologists who specialize in breast cancer, a medical physicist and a patient representative. The guideline was approved by ASTRO's Board of Directors following a period of public comment. The guideline has been endorsed by the Royal Australian and New Zealand College of Radiologists (RANZCR) and the Society of Surgical Oncology (SSO).

ASTRO's clinical guidelines are intended as a tool to promote appropriately individualized, shared decision-making between physicians and patients. None should be construed as strict or superseding the appropriately informed and considered judgments of individual physicians and patients.

"Radiation Therapy for the Whole Breast: An American Society for Radiation Oncology (ASTRO) Evidence-Based Guideline" is available as a free access article in Practical Radiation Oncology, ASTRO's clinical practice journal. For a copy of the guideline or to interview Dr. Smith, Dr. Jagsi or outside experts in breast cancer, contact ASTRO's media relations team at press@astro.org or 703-286-1600.


ABOUT ASTRO
The American Society for Radiation Oncology (ASTRO) is the world's largest radiation oncology society, with more than 10,000 members who are physicians, nurses, biologists, physicists, radiation therapists, dosimetrists and other health care professionals who specialize in treating patients with radiation therapies. The Society is dedicated to improving patient care through professional education and training, support for clinical practice and health policy standards, advancement of science and research, and advocacy. ASTRO publishes three peer-reviewed journals, the International Journal of Radiation Oncology • Biology • Physics (redjournal.org), Practical Radiation Oncology (practicalradonc.org) and Advances in Radiation Oncology (advancesradonc.org); developed and maintains an extensive patient website, RT Answers (rtanswers.org); and created the Radiation Oncology Institute (roinstitute.org), a nonprofit foundation to support research and education efforts around the world that enhance and confirm the critical role of radiation therapy in improving cancer treatment. To learn more about ASTRO, visit www.astro.org, sign up to receive our news and follow us on our blog, Facebook and Twitter.

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