Latest SASCRO News

Congratulations to Successful Candidates

SASCRO Congratulates the following doctors who successfully passed the Part II of the FC Rad Onc(SA):
We look forward to working with you and trust that you will all contribute to Oncology in South Africa.

 

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SASCRO Fee Rules 2012

The SASCRO Radiation Fee Rules for 2012 are available here for download as well as the SASCRO SASMO Chemotherapy Fee Rules available here.

 

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APBI Guidelines

Since Accelerated Partial Breast Irradiation (APBI) has recently been available in SA, the SASCRO committee decided to adopt the ASTRO guidelines in this regard. ASTRO appointed a task force to review data and report back and the results was published in the Red Journal. Click here to read the Consensus Statement.

The task force created four categories to describe eligibility for APBI: suitable, cautionary, unsuitable, and unacceptable. APBI is considered unacceptable for women who are pregnant, have had prior radiation therapy treatment, or have a history of collagen vascular disease.

The other three categories of eligibility -- suitable, cautionary, and unsuitable -- cover women with a very low risk of clinically occult disease remote from the lumpectomy cavity. Selection criteria for the suitable group are based on characteristics of patients enrolled in prospective single-arm clinical studies who had a minimum of four years of follow-up. Members of the task force were comfortable identifying women as suitable for APBI based on the criteria for participants in the majority of clinical trials whose results have been positively reported.

Suitability requirements are listed below. If a patient has any factor in the cautionary list, the task force recommended that oncology care providers "invoke caution and concern." Similarly, if any patient has any characteristic listed in the unsuitable column, she should receive APBI only in the context of a clinical trial. Should a patient's final histology not fulfil all the criteria, additional standard EBRT might still be indicated post-operatively.

ASTRO consensus statement on APBI suitability factors

Factors	Suitable	Cautionary	Unsuitable
Age BRCA 1 or 2 mutation Tumor size T stage Margins Grade Lymph vascular space invasion Estrogen receptor status Multicentricity Multifocality Pure ductal carcinoma in situ Extensive intraductal component Associated lobular carcinoma in situ N stage Nodal surgery Neoadjuvant therapy	60 and older Not applicable Less than 2 cm T1 Negative by 2 mm Any No Positive Unicentric only Clinically unifocal with total size less than 2.0 cm Not allowed Not allowed Allowed pN0 (i-, i+) Sentinel lymph node biopsy or axillary lymph node dissection Not allowed	50-59 Not specified 2.1-3.0 cm T0 or T2 Close (less than 2 mm) Any Limited/focal Negative Clinically unifocal with total size 2.1-3.0 cm Clinically unifocal with total size 2.1-3.0 cm 3 cm or smaller 3 cm or smaller Not specified Not specified Not specified Not specified	Younger than 50 Present More than 3 cm T3 or T4 Positive Extensive Present If microscopically multifocal more than 3 cm in total size or if clinically multifocal More than 3 cm More than 3 cm Not specified pN1, pN2, pN3 None performed If used

Informed consent, diagnostic tests, and timing

Oncologists are advised to tell patients that the long-term effectiveness and safety of APBI treatment are not fully known, and they may have a higher risk of ipsilateral breast tumor recurrence. Patients should be informed of the increased risk of toxicity with APBI, including local fibrosis, fat necrosis, and poor cosmesis. Informed-consent statements must be signed prior to breast conservation surgery.

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Sample College Papers

The College curriculum changed recently and examples of papers for the new curriculum can be downloaded by clicking on the links displayed below

• Sample Radiobiology Paper
• Sample Anatomy Paper