CPB Ljubljana 2018 course book

INDICATIONS OF ADJUVANT BT

• BT alone after surgery and high risk features of local failure (i.e., positive margins, perineural inv.) if: 1. The high-risk area can be precisely defined (clips) 2. It is accessible to implantation 3. EBRT is not required or is contraindicated (prior irradiation) 4. A second surgery is not an option due to functional or cosmetic concerns.

• Doses of 15-20 Gy of LDR BT (or PDR/HDR equivalent).

• Adjuvant BT + EBRT allows for dose intensification and shortens the overall treatment time and decreases the external component. • Perioperative BT avoids a second intervention and ensures a precise definition of the high risk area