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

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