Controversies in Locoregional Care
Wednesday, December 6 • 3:10 p.m. – 5:00 p.m. • Hemisfair Ballroom 1-2
Presentation: When less is more: Patient-friendly radiation courses with WBI and PBI
Icro Meattini, MD
Università degli Studi di Firenze,
Florence, Italy
What is your presentation about?
My presentation will provide an overview of the most patient-friendly irradiation delivery strategies for both whole breast and partial breast irradiation. I will present and discuss key data on main disease control, rates of adverse events, cosmesis, and health-related quality of life from major published phase 3 trials. Additionally, I will highlight the pros and cons of each therapeutic approach, identify gray areas, and address the most debated open questions in the field. The presentation will include a summary of current guidelines, recommendations, and patient selection criteria. Furthermore, I will focus on optimization strategies for irradiation modalities, with an eye towards future perspectives in early breast cancer care.
What makes this topic important in 2023?
The current availability of highly effective strategies for both whole and partial breast irradiation following breast-conserving surgery has significantly improved the safety outcomes for patients, while maintaining excellent disease control. Depending on appropriate patient selection, as well as factors such as radiation therapy volume, technique, and fractionation choice, an optimized irradiation strategy consistently offers the potential to reduce the adverse events rate while preserving equivalent local control and enhancing patients’ health-related quality of life. However, several gray areas have emerged from major published trials, and the pros and cons of each available approach should always be discussed in a multidisciplinary fashion and shared with patients to avoid suboptimal practice.
How did you get involved in this particular area of breast cancer research, care, or advocacy?
I am a dedicated doctor passionate about international networking, mentorship, and delivering optimal patient care. Currently serving as an Associate Professor at the Department of Experimental and Clinical Biomedical Sciences ‘M. Serio’ at the University of Florence, Italy, I have been working as a clinical and radiation oncologist since 2011 at the Radiation Oncology Unit of the Oncology Department of Florence University Hospital. In this role, I lead the outpatient clinics unit, clinical trials unit, and the radiation oncology group of the breast cancer multidisciplinary team. I am an active member of prestigious societies such as the European Society for Radiotherapy & Oncology (ESTRO), European School of Oncology (ESO), European Society for Medical Oncology (ESMO), European Organisation for Research and Treatment of Cancer (EORTC), and the Italian Association of Radiation Oncology (AIRO). Within ESTRO, I serve as a clinical board member and contribute to the Guidelines Committee with a focus on breast cancer. I am also a member of the steering committee for the EORTC breast cancer group and the radiation oncology scientific council (ROSC). As the founder of the clinical oncology breast cancer group (COBCG) cooperative network, I actively promote collaboration in the field. Engaging in both principal and sub-investigator roles for several phase 2-3 trials, my primary areas of interest include breast cancer, multimodal treatments, oligometastatic disease, health-related quality of life, cardiac toxicity prevention, hypofractionation, partial breast irradiation, and clinical trial research. Notable achievements include co-leading the APBI-IMRT-Florence phase 3 trial (NCT02104895), authoring the ESTRO recommendations on patient selection and dose and fractionation for external beam radiotherapy in early breast cancer, and serving as the principal investigator for the EUROPA phase 3 trial (NCT04134598). This trial investigates the impact on health-related quality of life of omitting radiation therapy or endocrine therapy in patients affected by very low-risk early breast cancer.