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Consensus statement on tumour bed localization for radiation after oncoplastic breast surgery

机译：肿瘤床疗法辐射后肿瘤定位的共识陈述

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Background: Oncoplastic surgery (OPS) is becoming the new standard of care for breast-conserving surgery.  OPS has led to some challenges with adjuvant radiation, particularly when accurate tumour bed (TB) delineation is needed for focused radiation (i.e. accelerated partial breast radiation or boost radiation).  Currently, there on no guidelines on tumour bed localization for adjuvant targeted radiation after OPS.Methods: A modified-Delphi method was used to establish consensus amongst a panel of 20 experts in surgical and radiation oncology at the Canadian Locally Advanced Breast Cancer National Consensus (LABCNC) Group and in subsequent online surveys.Results: The main recommendations are as follows: 1) Surgical clips are necessary and should, at a minimum, be placed along the four side walls of the cavity plus one to four clips at the posterior margin if necessary; 2) Operative reports should include pertinent information to help guide the radiation oncologists; 3) Breast surgeons and radiation oncologists should have a basic understanding of OPS techniques and work on “speaking a common language”; and 4) Careful consideration is needed when determining the value of targeted radiation, like boost, in higher level OPS procedures with extensive tissue rearrangement.Conclusion: The panel developed a total of six recommendations on TB delineation for more focused radiation therapy after OPS, with over 80% agreement on each statement.  These are summarized along with the corresponding evidence and/or expert opinion.
机译：背景：蜂胶塑造外科（OPS）正在成为哺乳母系手术的新标准。 OPS导致了辅助辐射的一些挑战，特别是当聚焦辐射需要精确的肿瘤床（TB）描绘时（即加速的部分乳房辐射或升压辐射）。目前，在OPS中没有关于佐剂靶向辐射的肿瘤床位定位指南。方法：改进的德尔福法在加拿大局部晚期乳腺癌全国共识的同介绍和放射肿瘤学专家组中建立共识（ LabCNC）组和随后的在线调查。结果：主要建议如下：1）手术夹是必要的，并且应该最小，沿着腔的四个侧壁加上一到四个夹子在后缘上放置一到四个夹子如有必要; 2）操作报告应包括有关信息，以帮助指导辐射脑管理学家; 3）胸部外科医生和辐射肿瘤学家应该对OPS技术的基本了解，并在“谈论共同语言”; 4）在确定具有广泛组织重新排列的较高水平的OPS程序中确定有针对性辐射的值时需要仔细考虑。结论：面板在OPS后的更多聚焦放射治疗的TB划分方案开发了六项建议。每次陈述有超过80％的协议。这些总结了相应的证据和/或专家意见。

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