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Breast conservative boost

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https://www.readbyqxmd.com/read/27908586/standard-wide-local-excision-or-bilateral-reduction-mammoplasty-in-large-breasted-women-with-small-tumours-surgical-and-patient-reported-outcomes
#1
R Di Micco, R L O'Connell, P A Barry, N Roche, F A MacNeill, J E Rusby
INTRODUCTION: Oncoplastic breast surgery is used to extend the role of breast-conserving surgery (BCS) to women with an unfavourable tumour to breast volume ratio. However, large-breasted women with a relatively small breast cancer may be offered bilateral reduction mammoplasty (BRM) despite being suitable for standard BCS as the more complex surgery may have advantages in terms of patient satisfaction and reduced adverse effects of radiotherapy. PATIENT AND METHODS: This retrospective study evaluated surgical and patient-reported outcome measures (PROMs) in large-breasted women with early (<3 cm) breast cancer, who have undergone unilateral standard BCS or BRM...
November 17, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27862181/identification-of-biomarker-by-treatment-interactions-in-randomized-clinical-trials-with-survival-outcomes-and-high-dimensional-spaces
#2
Nils Ternès, Federico Rotolo, Georg Heinze, Stefan Michiels
Stratified medicine seeks to identify biomarkers or parsimonious gene signatures distinguishing patients that will benefit most from a targeted treatment. We evaluated 12 approaches in high-dimensional Cox models in randomized clinical trials: penalization of the biomarker main effects and biomarker-by-treatment interactions (full-lasso, three kinds of adaptive lasso, ridge+lasso and group-lasso); dimensionality reduction of the main effect matrix via linear combinations (PCA+lasso (where PCA is principal components analysis) or PLS+lasso (where PLS is partial least squares)); penalization of modified covariates or of the arm-specific biomarker effects (two-I model); gradient boosting; and univariate approach with control of multiple testing...
November 15, 2016: Biometrical Journal. Biometrische Zeitschrift
https://www.readbyqxmd.com/read/27858093/targeted-intraoperative-radiotherapy-tumour-bed-boost-during-breast-conserving-surgery-after-neoadjuvant-chemotherapy
#3
Hans-Christian Kolberg, Gyoergy Loevey, Leyla Akpolat-Basci, Miltiades Stephanou, Peter A Fasching, Michael Untch, Cornelia Liedtke, Max Bulsara, Jayant S Vaidya
INTRODUCTION: The use of targeted intraoperative radiotherapy (TARGIT-IORT) as a tumour bed boost during breast-conserving surgery (BCS) for breast cancer has been reported since 1998. We present its use in patients undergoing breast conservation following neoadjuvant therapy (NACT). METHOD: In this retrospective study involving 116 patients after NACT we compared outcomes of 61 patients who received a tumour bed boost with IORT during lumpectomy versus 55 patients treated in the previous 13 months with external (EBRT) boost...
November 17, 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/27803600/use-of-low-value-radiotherapy-practices-in-canada-an-analysis-of-provincial-cancer-registry-data
#4
K Tran, R Rahal, M Brundage, S Fung, C Louzado, M Milosevic, J Xu, H Bryant
BACKGROUND: As part of Choosing Wisely Canada (a national campaign to encourage patient-provider conversations about unnecessary medical tests, treatments, and procedures), a list of ten oncology practices that could be low-value in some instances was developed. Of those practices, two were specific to radiation therapy (rt): conventional fractionation as part of breast-conserving therapy (bct) for women with early-stage breast cancer, and multifraction radiation for palliation of uncomplicated painful bone metastases...
October 2016: Current Oncology
https://www.readbyqxmd.com/read/27793444/radiation-induced-fibrosis-in-the-boost-area-after-three-dimensional-conformal-radiotherapy-with-a-simultaneous-integrated-boost-technique-for-early-stage-breast-cancer-a-multivariable-prediction-model
#5
C Hammer, J H Maduro, E J Bantema-Joppe, A van der Schaaf, H P van der Laan, J A Langendijk, A P G Crijns
BACKGROUND AND PURPOSE: To develop a multivariable prediction model for the risk of grade⩾2 fibrosis in the boost area after breast conserving surgery (BCS) followed by three-dimensional conformal radiotherapy (RT) with a simultaneous integrated photon boost (3D-CRT-SIB), five years after RT. MATERIAL AND METHODS: This prospective cohort study included 1,030 patients treated with RT for breast cancer (stage 0-III), after BCS. Data regarding physician-rated fibrosis and dose-volume parameters were available in 546 patients...
October 25, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/27716877/simultaneous-integrated-bilateral-breast-and-nodal-irradiation-with-volumetric-arc-therapy-case-report-and-literature-review
#6
Alba Fiorentino, Umberto Tebano, Ruggero Ruggieri, Francesco Ricchetti, Filippo Alongi
AIM: For simultaneous bilateral breast cancer (SBBC) treatment, conventional radiotherapy (RT) has a number of critical shortcomings. Thus, the usefulness of volumetric arc therapy (VMAT) for SBBC is undeniable. CASE REPORT: A 34-year-old woman with SBBC received neoadjuvant chemotherapy followed by breast-conserving surgery and bilateral lymph node dissection. Given the conservative surgery and the nodal involvement after neoadjuvant chemotherapy, bilateral adjuvant RT to the breasts and regional nodes with doses of 50 Gy in 25 fractions and a simultaneous integrated boost (SIB) of 60 Gy to the surgical bed was proposed...
September 27, 2016: Tumori
https://www.readbyqxmd.com/read/27709273/impact-of-a-novel-bioabsorbable-implant-on-radiation-treatment-planning-for-breast-cancer
#7
Michael J Cross, Gail S Lebovic, Joseph Ross, Scott Jones, Arnold Smith, Steven Harms
BACKGROUND: Techniques for accurately delineating the tumor bed after breast-conserving surgery (BCS) can be challenging. As a result, the accuracy, and efficiency of radiation treatment (RT) planning can be negatively impacted. Surgically placed clips or the post-surgical seroma are commonly used to determine target volume; however, these methods can lead to a high degree of uncertainty and variability. A novel 3-dimensional bioabsorbable marker was used during BCS and assessed for its impact on RT planning...
October 5, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27689969/an-international-randomised-controlled-trial-to-compare-targeted-intraoperative-radiotherapy-targit-with-conventional-postoperative-radiotherapy-after-breast-conserving-surgery-for-women-with-early-stage-breast-cancer-the-targit-a-trial
#8
Jayant S Vaidya, Frederik Wenz, Max Bulsara, Jeffrey S Tobias, David J Joseph, Christobel Saunders, Chris Brew-Graves, Ingrid Potyka, Stephen Morris, Hrisheekesh J Vaidya, Norman R Williams, Michael Baum
BACKGROUND: Based on our laboratory work and clinical trials we hypothesised that radiotherapy after lumpectomy for breast cancer could be restricted to the tumour bed. In collaboration with the industry we developed a new radiotherapy device and a new surgical operation for delivering single-dose radiation to the tumour bed - the tissues at highest risk of local recurrence. We named it TARGeted Intraoperative radioTherapy (TARGIT). From 1998 we confirmed its feasibility and safety in pilot studies...
September 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27675796/acute-toxicity-effect-of-hypofractionated-whole-breast-radiation-therapy-with-simultaneous-boost-of-the-tumor-bed-in-patients-with-breast-conserving-treatment
#9
J Luo, Z Zhou, X Chen, Z Yang, J Ma, X Mei, L Zhang, Q C Hu, X Guo, X Yu
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27675127/targeted-intraoperative-radiation-therapy-tumor-bed-boost-during-breast-conserving-surgery-after-neoadjuvant-chemotherapy-in-tnbc-and-her2-positive-breast-cancer
#10
H C Kolberg, G Loevey, L Akpolat-Basci, M Stephanou, P A Fasching, M Untch, C Liedtke, M Bulsara, J S Vaidya
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27674045/a-topology-based-method-to-mitigate-boost-volume-uncertainty-for-breast-conservative-therapy
#11
P Y Lee, C N Chu, J A Liang, S W Chen, K S C Chao, C Y Lin
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27648082/external-beam-boost-versus-interstitial-high-dose-rate-brachytherapy-boost-in-the-adjuvant-radiotherapy-following-breast-conserving-therapy-in-early-stage-breast-cancer-a-dosimetric-comparison
#12
Martje Marie Terheyden, Corinna Melchert, György Kovács
PURPOSE: This study aims to compare the dosimetric data of local tumor's bed dose escalation (boost) with photon beams (external beam radiation therapy - EBRT) versus high-dose-rate interstitial brachytherapy (HDR-BT) after breast-conserving treatment in women with early-stage breast cancer. MATERIAL AND METHODS: We analyzed the treatment planning data of 136 irradiated patients, treated between 2006 and 2013, who underwent breast-conserving surgery and adjuvant whole breast irradiation (WBI; 50...
August 2016: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/27639373/phase-ii-trial-of-hypofractionated-vmat-based-treatment-for-early-stage-breast-cancer-2-year-toxicity-and-clinical-results
#13
Fiorenza De Rose, Antonella Fogliata, Davide Franceschini, Piera Navarria, Elisa Villa, Cristina Iftode, Giuseppe D'Agostino, Luca Cozzi, Francesca Lobefalo, Pietro Mancosu, Stefano Tomatis, Marta Scorsetti
BACKGROUND: To report toxicity and early clinical outcomes of hypofractionated simultaneous integrated boost (SIB) approach with Volumetric Modulated Arc Therapy (VMAT) as adjuvant treatment after breast-conserving surgery. METHODS: Patients presenting early-stage breast cancer were enrolled in a phase II trial. ELIGIBILITY CRITERIA: age > 18 years old, invasive cancer or ductal carcinoma in situ (DCIS), Stage I-II (T < 3 cm and N ≤ 3), breast-conserving surgery without oncoplastic reconstruction...
September 17, 2016: Radiation Oncology
https://www.readbyqxmd.com/read/27614516/-hypofractionated-whole-breast-irradiation-wbrt-results-and-indications
#14
B Cutuli
Breast irradiation after breast-conserving surgery is essential for maximizing local control and overall survival. The increase of breast cancer (BC) incidence, constraints of classical five weeks (w) radiation regimens and scarcity of radiotherapy units have led to test short hypofractionated WBRT schemes. One pilot study and three prospective randomized trials have tested various hypofractionated regimens of WBRT. About 7000 patients were included and follow-up ranged from 5 to 12 years. The conclusion of these trials is similar, showing local control and toxicity equivalent to these of the standard regimens...
October 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/27607734/prognostic-factors-for-local-control-in-breast-cancer-after-long-term-follow-up-in-the-eortc-boost-vs-no-boost-trial-a-randomized-clinical-trial
#15
Conny Vrieling, Erik van Werkhoven, Philippe Maingon, Philip Poortmans, Caroline Weltens, Alain Fourquet, Dominic Schinagl, Bing Oei, Carla C Rodenhuis, Jean-Claude Horiot, Henk Struikmans, Erik Van Limbergen, Youlia Kirova, Paula Elkhuizen, Rudolf Bongartz, Raymond Miralbell, David A L Morgan, Jean-Bernard Dubois, Vincent Remouchamps, René-Olivier Mirimanoff, Guus Hart, Sandra Collette, Laurence Collette, Harry Bartelink
Importance: Prognostic factors of ipsilateral breast tumor recurrence (IBTR) may change over time following breast-conserving therapy. Objective: The EORTC "boost no boost" trial showed that young age and high-grade invasive carcinoma were the most important risk factors for IBTR. This study reanalyses pathological prognostic factors related to IBTR using long-term follow-up. Design, Setting, and Participants: Participants included 5569 early-stage breast cancer patients, treated with breast-conserving surgery (BCS) and whole-breast irradiation (WBI), who were randomized between no boost and a 16-Gy boost in the EORTC phase III "boost no boost" trial (1989-1996)...
September 8, 2016: JAMA Oncology
https://www.readbyqxmd.com/read/27579310/comprehensive-evaluation-of-personal-clinical-and-radiation-dosimetric-parameters-for-acute-skin-reaction-during-whole-breast-radiotherapy
#16
Dae Sik Yang, Jung Ae Lee, Won Sup Yoon, Nam Kwon Lee, Young Je Park, Suk Lee, Chul Yong Kim, Gil Soo Son
Skin reaction is major problem during whole breast radiotherapy. To identify factors related to skin reactions during whole breast radiotherapy, various personal, clinical, and radiation dosimetric parameters were evaluated. From January 2012 to December 2013, a total of 125 patients who underwent breast conserving surgery and adjuvant whole breast irradiation were retrospectively reviewed. All patients had both whole breast irradiation and boost to the tumour bed. Skin reaction was measured on the first day of boost therapy based on photography of the radiation field and medical records...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27573380/hypofractionation-with-no-boost-after-breast-conservation-in-early-stage-breast-cancer-patients
#17
Francesca Arcadipane, Pierfrancesco Franco, Chiara De Colle, Nadia Rondi, Jacopo Di Muzio, Emanuela Pelle, Stefania Martini, Ada Ala, Mario Airoldi, Michela Donadio, Corrado De Sanctis, Isabella Castellano, Riccardo Ragona, Umberto Ricardi
The aim of this study was to evaluate local control, survival and toxicity profile of a consecutive cohort of early-stage breast cancer (EBC) patients treated with adjuvant hypofractionated radiotherapy (HF) with no boost delivered to the lumpectomy cavity, after breast-conserving surgery (BCS). Between 2005 and 2015, a total of 493 women affected with EBC were treated with HF (46 Gy/20 fractions or 40.05 Gy/15 fractions) to the whole breast without boost to tumor bed, because of age and/or favorable tumor characteristics...
October 2016: Medical Oncology
https://www.readbyqxmd.com/read/27494965/-not-available
#18
Bruno Cutuli
REFLEXIONS ABOUT NEW STRATEGIES OF RADIOTHERAPY FOR EARLY BREAST CANCER: Radiotherapy (RT) remains a major treatment element in early breast cancer, with a major impact on local control and survival. For ductal carcinoma in situ (DCIS), RT reduces local recurrence (LR) rates by 50 to 60 % after conservative surgery (both in situ and invasive). This was confirmed by four randomized trials and one meta-analysis. For infiltrating breast cancers (IBC), RT also reduces LR rates by 65 to 75 % after conservative surgery...
June 2016: Bulletin du Cancer
https://www.readbyqxmd.com/read/27476083/factors-influencing-acute-and-late-toxicity-in-the-era-of-adjuvant-hypofractionated-breast-radiotherapy
#19
M C De Santis, F Bonfantini, F Di Salvo, M Dispinzieri, E Mantero, F Soncini, P Baili, M Sant, G Bianchi, C Maggi, S Di Cosimo, R Agresti, E Pignoli, R Valdagni, L Lozza
PURPOSE: To evaluate toxicity in breast cancer patients treated with anthracycline and taxane based chemotherapy and whole breast hypofractionated radiotherapy, and to identify the risk factors for toxicity. METHODS AND MATERIALS: 537 early breast cancer patients receiving hypofractionated radiotherapy after conservative surgery were enrolled from April 2009 to December 2014, in an Italian cancer institute. The dose was 42.4 Gy in 16 daily fractions, 2.65 Gy per fraction...
October 2016: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/27474504/10-year-follow-up-of-621-patients-treated-using-high-dose-rate-brachytherapy-as-ambulatory-boost-technique-in-conservative-breast-cancer-treatment
#20
Laurent Quéro, Sophie Guillerm, Naila Taright, Sophie Michaud, Luis Teixeira, Laurence Cahen-Doidy, Edwige Bourstyn, Marc Espié, Christophe Hennequin
PURPOSE: Breast conserving treatment, consisting of lumpectomy followed by whole-breast irradiation, is considered the standard of care in early-stage breast cancer. Randomized studies have reported that delivering boost doses to tumor bed improves local control rates, particularly in young women. This study sought to evaluate local control and cosmetic results of delivering boost doses using a high-dose-rate (HDR) brachytherapy (HDRBT) in breast cancer conservative treatment. METHODS: We included 621 T1-T2, N0-N1 breast cancer patients who underwent lumpectomy, external irradiation (44Gy over 5weeks), and a boost dose of two fractions of 5Gy to the tumor bed by means of HDR iridium brachytherapy...
July 26, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
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