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Breast conservative boost

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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Canhua Xiao, Andrew H Miller, Jennifer Felger, Donna Mister, Tian Liu, Mylin A Torres
PURPOSE/OBJECTIVE: The purpose of this study was to examine the impact of radiotherapy on quality of life (QOL) of breast cancer patients during and until 1 year post radiotherapy treatment. METHODS AND MATERIALS: Thirty-nine breast cancer patients treated with breast conserving surgery were enrolled in a prospective study prior to whole breast radiotherapy (50 Gy plus a 10 Gy boost). No patient received chemotherapy. Data were collected before, at week 6 of radiotherapy, 6 weeks, and 1 year post-radiotherapy...
January 2016: Advances in Radiation Oncology
Maria C De Santis, Luigia Nardone, Barbara Diletto, Roberta Canna, Michela Dispinzieri, Lorenza Marino, Laura Lozza, Vincenzo Valentini
OBJECTIVE: After breast conservative surgery (BCS) and whole-breast radiotherapy (WBRT), the use of boost irradiation is recommended especially in patients at high risk. However, the standard technique and the definition of the boost volume have not been well defined. METHODS: We retrospectively compared an anticipated pre-operative photon boost on the tumour, administered with low-dose fractionated radiotherapy, and neoadjuvant chemotherapy with two different sequential boost techniques, administered after BCS and standard adjuvant WBRT: (1) a standard photon beam (2) and an electron beam technique on the tumour bed of the same patients...
October 2016: British Journal of Radiology
Sang-Won Kim, Doo Ho Choi, Seung Jae Huh, Won Park, Seok Jin Nam, Seok Won Kim, Jeong Eon Lee, Young-Hyuck Im, Jin Seok Ahn, Yeon Hee Park
PURPOSE: We analyzed the association of lymph node ratio (LNR) wth locoregional control (LRC) in breast cancer patients with ≥10 involved axillary lymph nodes who underwent multimodality treatment. METHODS: We retrospectively analyzed 234 breast cancer patients with ≥10 involved axillary lymph nodes between 2000 and 2011. All patients received adjuvant chemotherapy and radiotherapy (RT) after radical surgery. The cutoff value of LNR was obtained using receiver operating characteristic curve analysis...
June 2016: Journal of Breast Cancer
B Cutuli, N Wiezzane, I Palumbo, P Barbieri, M Guenzi, A Huscher, S Borghesi, C Delva, T Iannone, E Vianello, M-E Rosetto, C Aristei
PURPOSE: Ductal carcinoma in situ represents 15 to 20% of all breast cancers. Breast-conserving surgery and whole breast irradiation was performed in about 60% of the cases. This study reports local recurrence rates in patients with ductal carcinoma in situ treated by breast-conserving surgery and whole breast irradiation with or without boost and/or tamoxifen and compares different therapeutic options in two European countries. PATIENTS AND METHODS: From 1998 to 2007, 819 patients with pure ductal carcinoma in situ were collected, both in France (266) and Italy (553)...
June 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Shigeo Takahashi, Yuji Murakami, Nobuki Imano, Yuko Kaneyasu, Yoshiko Doi, Masahiro Kenjo, Tomoki Kimura, Takayuki Kadoya, Koji Arihiro, Tsuyoshi Kataoka, Morihito Okada, Yasushi Nagata
PURPOSE: The long-term outcomes of whole-breast and boost irradiation after breast-conserving surgery (BCS) for patients with breast cancer were retrospectively analyzed. MATERIALS AND METHODS: Patients who received whole-breast and boost irradiation after BCS from 1990 to 2002 were included. Boost irradiation was administered to each tumor bed, regardless of the surgical margin status. The median doses of whole-breast and boost irradiation were 45 Gy in 25 fractions (range 36-45 Gy), and 14 Gy in 7 fractions (range 0-14 Gy), respectively...
September 2016: Japanese Journal of Radiology
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