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| LETTER TO EDITOR |
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| Year : 2009 | Volume
: 5
| Issue : 4 | Page : 332 |
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Authors' reply
Tabassum Wadasadawala1, Rajiv Sarin1, Ashwini Budrukkar1, Rakesh Jalali1, Munshi Anusheel1, Rajendra Badwe2
1 Depatment of Radiation Oncology, Tata Memorial Hospital, Mumbai, India
2 Depatment of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
| Date of Web Publication | 11-Feb-2010 |
Correspondence Address:
Rajiv Sarin
Director, Advanced Centre for Treatment, Research & Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai - 410 210
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0973-1482.59896
How to cite this article:
Wadasadawala T, Sarin R, Budrukkar A, Jalali R, Anusheel M, Badwe R. Authors' reply. J Can Res Ther 2009;5:332 |
Sir,
We appreciate the issues raised in this letter [1] regarding Accelerated Partial Breast Irradiation (APBI). [2] Firstly, we have not made any claim that APBI is superior to the conventional Whole Breast Radiotherapy (WBRT) technique. Through this matched case-control study, we have shown how APBI, which may permit Breast Conserving therapy (BCT) to be offered to more women due to its abbreviated nature, is not associated with adverse local control or cosmetic outcome. As we have discussed in the article, this issue would be finally resolved in the next 5 to 10 years when the results of the ongoing randomized trial would become available; and this is preliminary data on Indian patients with tumor size larger than that seen in most studies published from North America or Europe.
The issue of "the required period of time for practicing the new technique should be compared to that required for the conventional technique" raised in this letter can be approached in several ways. The term accelerated itself implies the time advantage of this therapeutic approach for the patients - 1 week versus 7 weeks. In addition, the two techniques will require different time commitments from the professionals involved - radiation oncologist, medical physicist and Radiotherapy (RT) technician. While this requires a detailed study, carried out in different kinds of health care setups, according to our experience the time required for the two techniques is as listed in the table below.[Additional file 1]
The other important issue raised in this letter is about the cost-effectiveness of APBI. In fact, we have recently published a comparison of quality of life, including socioeconomic factors and financial difficulties, between APBI and WBRT. [3] We found that women treated with 1 week of APBI experienced lesser financial difficulties as compared to those treated with 7 weeks of conventional WBRT. This is not surprising considering that the majority of the patients, who are from a place outside Mumbai, incur heavy expenses for prolonged stay in a metropolis along with their relatives. Even those who live in Mumbai have to travel daily with an accompanying person and both have to spend almost half a day away from their homes and work for 7 weeks.
| > References | |  |
| 1. | Wiwanitkit V. APBI technique for whole-breast radiotherapy: A concern. J Cancer Res Ther 2009;5:331. 
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| 2. | Wadasadawala T, Sarin R, Budrukkar A, Jalali R, Munshi A, Badwe R. Accelerated partial-breast irradiation vs conventional whole-breast radiotherapy in early breast cancer: A case-control study of disease control, cosmesis, and complications. J Cancer Res Ther 2009;5:93-101.
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| 3. | Wadasadawala T, Budrukkar A, Chopra S, Badwe R, Hawaldar R, Parmar V, et al. Quality of Life after Accelerated Partial Breast Irradiation in Early Breast Cancer: Matched Pair Analysis with Protracted Whole Breast Radiotherapy. Clin Oncol 2009;21:668-675.
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