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Journal of Cancer Research and Therapeutics, Vol. 5, No. 4, October-December, 2009, pp. 332 Letter To Editor Authors' reply Wadasadawala Tabassum, Sarin Rajiv, Budrukkar Ashwini, Jalali Rakesh, Anusheel Munshi, Badwe Rajendra Depatment of Radiation Oncology, Tata Memorial Hospital, Mumbai Code Number: cr09083 DOI: 10.4103/0973-1482.59896 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. 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
Copyright 2009 - Journal of Cancer Research and Therapeutics The following images related to this document are available:Photo images[cr09083t1.jpg] |
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