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Table 5 Comparison of the current available APBI techniques (adapted from Sarin [135]), MIB = multicatheter Interstitial brachytherapy, IORT = intraoperative radiation therapy, RCT = randomized Clinical trials, OAR organ at risk

From: Accelerated Partial Breast Irradiation (APBI): A review of available techniques

  MIB Balloon based brachytherapy Hybrid based brachytherapy External beam IORT
   Mammosite Axxent Electronic Contura SAVI ClearPath Photons Electrons Protons electrons Photons
Prescription point 1.5 - 2 cm 1 cm 1 cm 1 cm 1 cm 1 cm 1.5 - 2 cm 1.5 - 2 cm 1.5-2 cm 10- 30 mm 2 mm
Coverage of target volume Variable Good Good Good Good Good Best Good Best Good Good
Dose Homogeneity Fair Fair Fair Fair Fair Fair Best Fair Best Fair Fair
Sparing of OAR Good Good Better Better Better Better Least Varies Good Good Best
Skin Dose Least Variable variable variable variable variable Least maximum Least Least Least
Expertise required High Average Average Average Average Average Average Least High Very High High
Suitability for various tumor size, location and shape Not suitable if inadequate tissue or near axilla Not suitable for large/irregular cavities or at the periphery Not suitable Large cavities Not suitable Large cavities Not suitable Large cavities Not suitable Large cavities May not be suitable for small breast Not suited for deep seated cavities in large breast Superficial tumor Not suitable for tumors near brachial plexus/axilla or skin Not suitable for large irregular cavities or at the periphery of breast
Potential for wide spread use Fair Very good Very good Very good Very good Very good Very good Very good Limited limited fair
Clinical outcome data 11 years case studies 5 years case studies None Limited Limited None 4.5 years case studies 8 years case studies Limited 4 years Case studies 4 years RCT
Main drawback High expertise required and QA Stringent QA is required Cavity, shape and size Cavity shape and size Cavity shape and size Treatment planning complex Treatment planning complex Setup and breathing errors High skin Dose Expensive and 2nd neutrons Pathology not available Pathology not available