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Breast conservative boost

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https://www.readbyqxmd.com/read/29116237/advantages-of-a-technique-using-two-50-degree-arcs-in-simultaneous-integrated-boost-radiotherapy-for-left-sidebreast-cancer
#1
Dan Xi, Yun Ding, Rui Hu, Wendong Gu, Jinming Mu, Qilin Li
This study evaluated radiotherapy techniques with 15 cases for simultaneous integrated boost to treat whole left breast and tumor bed following breast conserving surgery. Treatment plans were generated using three techniques: volumetric modulated arc therapy (VMAT) with a partial arc of 190° (1ARC), VMAT with two tangential mini-arcs of 50° each (2TARC) and intensity modulated radiation therapy with four fixed angle fields (4IMRT). Dosimetric parameters for the whole breast (Target), the boost tumor bed (Boost), and surrounding normal organs were compared...
November 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29105051/tumour-bed-boost-radiotherapy-for-women-after-breast-conserving-surgery
#2
REVIEW
Isabelle Kindts, Annouschka Laenen, Tom Depuydt, Caroline Weltens
BACKGROUND: Breast-conserving therapy, involving breast-conserving surgery followed by whole-breast irradiation and optionally a boost to the tumour bed, is a standard therapeutic option for women with early-stage breast cancer. A boost to the tumour bed means that an extra dose of radiation is applied that covers the initial tumour site. The rationale for a boost of radiotherapy to the tumour bed is that (i) local recurrence occurs mostly at the site of the primary tumour because remaining microscopic tumour cells are most likely situated there; and (ii) radiation can eliminate these causative microscopic tumour cells...
November 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29102277/short-term-follow-up-mammography-in-breast-conservation-therapy-likely-leads-to-unnecessary-downstream-workup-a-longitudinal-study
#3
Shaakir Hasan, Stephen Abel, LaShondria Simpson-Camp, Meredith Witten, Luis Aguilera, Leslie Teng, Frances Hite Philp, Thomas B Julian, Mark Trombetta, Stephen Karlovits, Michael Cowher
PURPOSE: To analyze the effect of post-radiation therapy (XRT) mammographic timing and radiation technique in relation to additional downstream workup for 569 breast conservation therapy patients treated with adjuvant XRT after their initial surveillance mammogram (MMG). METHODS AND MATERIALS: From January 2011 to December 2014, 569 breast cancer patients treated with breast conservation surgery and adjuvant XRT with a follow-up MMG were reviewed. Patients were stratified by the time interval until their first post-XRT MMG, and by XRT technique-whole breast (472), accelerated partial breast (96), conventional fractionation (373), hypofractionation (94), surgical cavity boosts (407), or no boost (66)...
September 21, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29032999/a-prospective-phase-i-comparison-of-toxicity-and-cosmesis-outcomes-of-single-fraction-iort-and-hypofractionated-radiotherapy-with-iort-boost-in-early-stage-breast-cancer
#4
Tanuja Bhandari, Wesley Babaran, Afshin Forouzannia, Venita Williams, Jay Harness, Michele Carpenter, Maher Gobran, Rajesh Khanijou, Brittany Wagman, Robert Ash, Lawrence D Wagman
PURPOSE: Radiation therapy is proven to reduce local recurrence in patients with early-stage breast cancer. To reduce toxicity, treatment time, and improve accuracy, intraoperative radiation therapy was used as definitive treatment or as a boost. The study's objective was to compare the short-term toxicity and cosmesis of single-fraction (SF) IORT and hypofractionated radiotherapy with IORT boost (HfB) given as definitive treatment. METHODS AND MATERIALS: Between March 2011 and December 2013, 57 patients aged 45-91 years and 24 patients aged 43-83 years (total n = 81) with Stage 0-II were treated with SF or HfB (Mobetron, IntraOp Medical, Sunnyvale, CA)...
October 9, 2017: Brachytherapy
https://www.readbyqxmd.com/read/28987136/radiation-therapy-and-early-breast-cancer-current-controversies
#5
REVIEW
John Boyages
Radiation therapy (RT) is an important component of breast cancer treatment. RT reduces local recurrence and breast cancer mortality after breast conservation for all patients and for node-positive patients after a mastectomy. Short courses of RT over 3-4 weeks are generally as effective as longer courses. A patient subgroup where RT can be avoided after conservative surgery has not been consistently identified. A radiation boost reduces the risk of a recurrence in the breast but may be omitted for older patients with good prognosis tumours with clear margins...
August 4, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28945885/single-fraction-radiosurgery-using-conservative-doses-for-brain-metastases-durable-responses-in-select-primaries-with-limited-toxicity
#6
Michael Cummings, Paul Youn, Derek P Bergsma, Kenneth Y Usuki, Kevin Walter, Manju Sharma, Paul Okunieff, Michael C Schell, Michael T Milano
BACKGROUND: Optimal doses for single-fraction stereotactic radiosurgery (SRS) in the treatment of brain metastases are not well established. Our institution utilized conservative dosing compared to maximum-tolerated doses from the Radiation Therapy Oncology Group 90-05 Phase I study. OBJECTIVE: To report individual lesion control (LC) from conservative single-fraction doses and determine factors affecting LC. METHODS: From 2003 to 2015, patients who underwent linear accelerator-based single-fraction SRS for cerebral/cerebellar metastases and receiving at least 1 follow-up magnetic resonance imaging (MRI) were identified...
August 12, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28928852/dcis-margins-and-breast-conservation-md-anderson-cancer-center-multidisciplinary-practice-guidelines-and-outcomes
#7
REVIEW
Henry M Kuerer, Benjamin D Smith, Mariana Chavez-MacGregor, Constance Albarracin, Carlos H Barcenas, Lumarie Santiago, Mary E Edgerton, Gaiane M Rauch, Sharon H Giordano, Aysegul Sahin, Savitri Krishnamurthy, Wendy Woodward, Debasish Tripathy, Wei T Yang, Kelly K Hunt
Recent published guidelines suggest that adequate margins for DCIS should be ≥ 2 mm after breast conserving surgery followed by radiotherapy (RT). Many groups now use this guideline as an absolute indication for additional surgery. This article describes detailed multidisciplinary practices including extensive preoperative/intraoperative pathologic/histologic image-guided assessment of margins, offering some patients with small low/intermediate grade DCIS no RT, the use/magnitude of radiation boost tailoring to margin width, and endocrine therapy for ER-positive DCIS...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28894737/fmeca-application-to-intraoperative-electron-beam-radiotherapy-procedure-as-a-quality-method-to-prevent-and-reduce-patient-s-risk-in-conservative-surgery-for-breast-cancer
#8
Cristiana Vidali, Mara Severgnini, Monica Urbani, Licia Toscano, Alfredo Perulli, Marina Bortul
INTRODUCTION: Failure Mode Effects and Criticalities Analysis (FMECA) represents a prospective method for risk assessment in complex medical practices. Our objective was to describe the application of FMECA approach to intraoperative electron beam radiotherapy (IOERT), delivered using a mobile linear accelerator, for the treatment of early breast cancer as an anticipated boost. MATERIALS AND METHODS: A multidisciplinary Working Group, including several different professional profiles, was created before the beginning of clinical practice in 2012, with the purpose of writing the Flow Chart and applying the FMECA methodology to IOERT procedure...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28874627/iort-in-breast-cancer-our-experience-of-the-first-patients-treated
#9
Andrea Morlino, Giuseppe La Torre, Loredana Lapadula, Aldo Cammarota
AIM: The aim of this study was to assess the therapeutic effect of intraoperative radiotherapy, describe the method and examine the results of our experience. BACKGROUND: Breast conserving therapy has recently become a standard treatment modality in patients with early invasive cancer. Radiotherapy, along with surgery, is an integral part of such treatment. The important thing of radiotherapy is to deliver a high dose to the tumour bed. One of the methods is the intraoperative radiotherapy...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28834326/proposal-for-a-gold-standard-for-cosmetic-evaluation-after-breast-conserving-therapy-results-from-the-st-george-and-wollongong-breast-boost-trial
#10
Roya Merie, Lois Browne, Jaime S Cardoso, Maria J Cardoso, Yaw Chin, Catherine Clark, Peter Graham, Alison Szwajcer, Eric Hau
INTRODUCTION: Breast cosmesis is an important endpoint of breast conserving therapy (BCT), but a gold standard method of its evaluation is not yet established. The St. George and Wollongong Randomised Breast Boost trial used five different methods of cosmetic assessment, including both subjective and objective, to comprehensively evaluate the cosmetic outcome of the trial patients. This current study analyses the level of concordance between these methods in an attempt to determine a possible standard in the evaluation of breast cosmesis...
August 18, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28797765/patterns-of-fractionation-and-boost-usage-in-adjuvant-external-beam-radiotherapy-for-ductal-carcinoma-in-situ-in-the-united-states
#11
William A Stokes, Arya Amini, Matthew W Jackson, S Reed Plimpton, Nicole Kounalakis, Peter Kabos, Rachel A Rabinovitch, Chad G Rusthoven, Christine M Fisher
BACKGROUND: While the roles of hypofractionated (HFxn) radiotherapy and lumpectomy boost in the adjuvant management of invasive breast cancer are supported by the results of clinical trials, randomized data supporting their use for ductal carcinoma in situ (DCIS) are forthcoming. We sought to evaluate current national trends and identify factors associated with HFxn and boost usage using the National Cancer Database. PATIENTS AND METHODS: We queried the National Cancer Database for women diagnosed with DCIS from 2004 to 2014 undergoing external beam radiotherapy after breast conservation surgery...
June 29, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28776318/ten-year-results-of-accelerated-hypofractionated-adjuvant-whole-breast-radiation-with-concomitant-boost-to-the-lumpectomy-cavity-after-conserving-surgery-for-early-breast-cancer
#12
Domenico Cante, Edoardo Petrucci, Piera Sciacero, Cristina Piva, Silvia Ferrario, Silvia Bagnera, Sebastiano Patania, Guido Mondini, Massimo Pasquino, Valeria Casanova Borca, Giorgio Vellani, Maria Rosa La Porta, Pierfrancesco Franco
Accelerated hypofractionated whole-breast radiotherapy (WBRT) is considered a standard therapeutic option for early breast cancer (EBC) in the postoperative setting after breast conservation (BCS). A boost to the lumpectomy cavity may further increase local control. We herein report on the 10-year results of a series of EBC patients treated after BCS with hypofractionated WBRT with a concomitant photon boost to the surgical bed over 4 weeks. Between 2005 and 2007, 178 EBC patients were treated with a basic course of radiotherapy consisting of 45 Gy to the whole breast in 20 fractions (2...
September 2017: Medical Oncology
https://www.readbyqxmd.com/read/28766200/keynote-address-at-the-american-society-of-breast-surgeons-18th-annual-meeting-current-and-future-application-of-intraoperative-radiotherapy-iort-in-the-curative-and-palliative-treatment-of-breast-cancer
#13
Frederik Wenz
Intraoperative radiotherapy (IORT) is increasingly used worldwide. Breast cancer is the most rapidly growing indication for IORT, approaching 70-80% of cases in most centers. This report reviews the theoretical background and clinical use of IORT for primary and metastasized breast cancer. There are established applications such as tumor bed boost during breast-conserving surgery followed by whole breast radiotherapy or IORT as a form of accelerated partial-breast irradiation (APBI) for selected patients. Novel applications such as IORT for vertebral or brain metastases are presented as well as technological developments, widening the spectrum of potential clinical applications for IORT...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28755327/comorbidities-and-intensity-modulated-radiotherapy-with-simultaneous-integrated-boost-in-elderly-breast-cancer-patients
#14
Alba Fiorentino, Rosario Mazzola, Niccolò Giaj Levra, Sergio Fersino, Francesco Ricchetti, Gioacchino Di Paola, Stefania Gori, Alberto Massocco, Filippo Alongi
PURPOSE: To evaluate the impact of comorbidity assessment on compliance to intensity modulated radiotherapy with simultaneous integrated boost (SIB-IMRT) in elderly patients affected by early stage breast cancer (BC). MATERIALS AND METHODS: 40 consecutive patients were treated with SIB-IMRT (50 Gy in 25 fractions to the whole breast, and simultaneously 60 Gy to the surgical bed) for invasive BC after conserving surgery. Inclusion criteria were: age ≥ 70 years, pT1-2 disease, pN0-1, no neoadjuvant chemotherapy, non-metastatic disease...
July 28, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28740451/mri-reduces-variation-of-contouring-for-boost-clinical-target-volume-in-breast-cancer-patients-without-surgical-clips-in-the-tumour-bed
#15
Noora Al-Hammadi, Palmira Caparrotti, Saju Divakar, Mohamed Riyas, Suparna Halsnad Chandramouli, Rabih Hammoud, Jillian Hayes, Maeve Mc Garry, Satheesh Prasad Paloor, Primoz Petric
BACKGROUND: Omitting the placement of clips inside tumour bed during breast cancer surgery poses a challenge for delineation of lumpectomy cavity clinical target volume (CTVLC). We aimed to quantify inter-observer variation and accuracy for CT- and MRI-based segmentation of CTVLC in patients without clips. PATIENTS AND METHODS: CT- and MRI-simulator images of 12 breast cancer patients, treated by breast conserving surgery and radiotherapy, were included in this study...
June 2017: Radiology and Oncology
https://www.readbyqxmd.com/read/28734546/whole-breast-radiotherapy-in-the-lateral-isocentric-lateral-decubitus-position-long-term-efficacy-and-toxicity-results
#16
Estelle Bronsart, Sylvain Dureau, Hao Ping Xu, Louis Bazire, Anne Chilles, Emilie Costa, Christelle Logerot, Marie-Christine Falcou, Francois Campana, Frédérique Berger, Alain Fourquet, Youlia M Kirova
PURPOSE: To evaluate previously published whole breast radiotherapy (WBRT) using ILD (isocentring lateral decubitus) technique in terms of toxicity and efficacy. MATERIALS AND METHODS: From 2006 to 2010, 832 female patients with early-stage breast cancer (BC) treated by conservative surgery underwent 3D-conformal WBRT-ILD at Institut Curie. The acute toxicity of treatment was evaluated weekly and the late toxicity (6months and later after the treatment) was evaluated every 6months till the 5th year after the end of the radiotherapy using NCI CTC v3...
August 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28643745/adjuvant-hypofractionated-radiation-in-carcinoma-breast-photon-versus-electron-comparison-of-treatment-outcome
#17
G Prameela Chelakkot, Rahul Ravind, K Sruthi, Namrata Chigurupati, Sanketh Kotne, Raghavendra Holla, Ram Madhavan, M Dinesh
BACKGROUND: Breast cancer tissue is sensitive to hypofractionation. This is an analysis of patients treated with hypofractionated protocols since 2009, at our tertiary cancer center. METHODS: Details of breast cancer patients treated with adjuvant hypofractionated external beam radiation therapy (EBRT) from January 2009 to December 2014 were retrieved and analyzed. RESULTS: One thousand seven hundred and eighty patients received adjuvant EBRT during this period...
April 2017: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28629952/analysis-of-outcomes-using-hypofractionated-tumor-bed-boost-combined-with-hypofractionated-whole-breast-irradiation-for-early-stage-breast-cancer
#18
Esther Yu, David Huang, Kara Leonard, Thomas Dipetrillo, David Wazer, Jaroslaw Hepel
INTRODUCTION: Tumor bed boost improves local control and is an important part of breast-conserving therapy. Data on the use of a hypofractioned tumor bed boost are needed. We performed a retrospective analysis of patients treated with hypofractionated whole breast irradiation (WBI) and hypofractionated boost to examine acute and delayed outcomes. MATERIALS AND METHODS: We examined the records of patients treated with hypofractionated WBI and tumor bed boost after lumpectomy for Stage 0 to II breast cancer...
May 25, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28608120/cosmetic-outcome-and-chronic-breast-toxicity-after-intraoperative-radiation-therapy-iort-as-a-single-modality-or-as-a-boost-using-the-intrabeam-%C3%A2-device-a-prospective-study
#19
Stéphane Key, Petra Miglierini, Pierre-François Dupré, Sandrine Guilbert, Anne-Sophie Lucia, Ronan Abgral, Virginie Conan-Charlet, Arnaud Uguen, Olivier Pradier, Ulrike Schick
PURPOSE: We aim to report our results in terms of chronic toxicities and cosmetic outcomes after intraoperative radiotherapy (IORT) using kV X-rays in women treated for early breast cancer at our institution. METHODS: Patients with early breast carcinoma were recruited between April 2011 and November 2014. After breast-conserving surgery, patients were treated with IORT using the Intrabeam(®) device. IORT was completed by whole-breast radiotherapy (WBRT) at a dose of 46-50...
June 12, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28581400/first-results-of-a-phase-2-trial-of-once-weekly-hypofractionated-breast-irradiation-whbi-for-early-stage-breast-cancer
#20
Anthony E Dragun, Nicholas J Ajkay, Elizabeth C Riley, Teresa L Roberts, Jianmin Pan, Shesh N Rai, Dharamvir Jain, Amy R Quillo, Charles R Scoggins, Kelly M McMasters, Shiao Y Woo
PURPOSE: To report early outcome analysis of a prospective institutional phase 2 trial of weekly hypofractionated breast irradiation (WHBI) for patients undergoing breast-conserving surgery (BCS). METHODS AND MATERIALS: Patients who underwent BCS for American Joint Committee on Cancer stage 0, I, or II breast cancer with negative surgical margins received whole-breast radiation therapy to 30 or 28.5 Gy in 5 weekly fractions with or without an additional boost. The eligibility criteria were the same as for NSABP (National Surgical Adjuvant Breast and Bowel Project) B39/RTOG (Radiation Therapy Oncology Group) 0413, and there were no restrictions on age, breast size, tumor grade, receptor status, or the use of cytotoxic chemotherapy for otherwise eligible patients...
July 1, 2017: International Journal of Radiation Oncology, Biology, Physics
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