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Letters to Editor Authors’ reply 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 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 — week versus 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 Time requirement in the table below 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 week of APBI experienced lesser financial difficulties as compared to those treated with 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 weeks Tabassum Wadasadawala, Rajiv Sarin, Ashwini Budrukkar, Rakesh Jalali, Munshi Anusheel, Rajendra Badwe1 Depatments of Radiation Oncology, 1Surgical Oncology, Tata Memorial Hospital, Mumbai, India For correspondence: Dr Rajiv Sarin, Director, Advanced Centre for Treatment, Research & Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai - 410 210, India E-mail: rsarin@actrec.gov.in DOI: 10.4103/0973-1482.59896 REFERENCES APBI WBRT (including tumor boost) hours 1.5 hours 1.5 hours 0.5 hour RT Technician hours hours Patient week 6-7 weeks Radiation Oncologist (procedure, planning and periodic review) Medical Physicist 332 Wiwanitkit V APBI technique for whole-breast radiotherapy: A concern J Cancer Res Ther 2009;5:331 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 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 J Cancer Res Ther - October-December 2009 - Volume - Issue Copyright of Journal of Cancer Research & Therapeutics is the property of Medknow Publications & Media Pvt Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use

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