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Radiation boost tumour bed breast

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
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
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
Florian Ebner, Nikolaus de Gregorio, Andreas Rempen, Peter Mohr, Amelie de Gregorio, Achim Wöckel, Wolfgang Janni, Gerlo Witucki
OBJECTIVE: Planning of breast radiation for patients with breast conserving surgery often relies on clinical markers such as scars. Lately, surgical clips have been used to identify the tumor location. The purpose of this study was to evaluate the geographic miss index (GMI) and the normal tissue index (NTI) for the electron boost in breast cancer treatment plans with and without surgical clips. MATERIAL AND METHODS: A retrospective descriptive study of 110 consecutive post-surgical patients who underwent breast-conserving treatment in early breast cancer, in which the clinical treatment field with the radiologic (clipped) field were compared and GMI/NTI for the electron boost were calculated respectively...
June 1, 2017: Journal of the Turkish German Gynecological Association
Icro Meattini, Calogero Saieva, Guido Miccinesi, Isacco Desideri, Giulio Francolini, Vieri Scotti, Livia Marrazzo, Stefania Pallotta, Fiammetta Meacci, Cristina Muntoni, Benedetta Bendinelli, Luis Jose Sanchez, Marco Bernini, Lorenzo Orzalesi, Jacopo Nori, Simonetta Bianchi, Lorenzo Livi
BACKGROUND: Accelerated partial breast irradiation (APBI) represents a valid option for selected early breast cancer (BC). We recently published the 5-year results of the APBI-IMRT-Florence phase 3 randomised trial (NCT02104895), showing a very low rate of disease failure, with acute and early-late toxicity in favour of APBI. We present the early and 2-year follow-up health-related quality of life (HRQoL) results. METHODS: Eligible patients were women aged more than 40 years with early BC suitable for breast-conserving surgery...
May 2017: European Journal of Cancer
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
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
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
A Fiorentino, R Mazzola, F Ricchetti, N Giaj Levra, S Fersino, S Naccarato, G Sicignano, R Ruggieri, G Di Paola, A Massocco, S Gori, F Alongi
PURPOSE: To investigate the feasibility and tolerance in the use of adjuvant intensity modulated radiation therapy (IMRT) and simultaneous integrated boost in patients with a diagnosis of breast cancer after breast-conserving surgery. PATIENTS AND METHODS: Between September 2011 to February 2013, 112 women with a diagnosis of early breast cancer (T1-2, N0-1, M0) were treated with IMRT and simultaneous integrated boost after breast-conserving surgery in our institution...
August 2015: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
O Lauche, D Azria, O Riou, M Charissoux, C Lemanski, C Bourgier
Breast cancers are highly radiosensitive since the risk of recurrences and of mortality after adjuvant radiotherapy following breast-conserving surgery is decreased by 15.7% and 3.8%, respectively at 10 years. The total dose if irradiation also significantly increases local control: a boost of 16 Gy to the tumour bed after breast-conserving surgery reduces the absolute risk of recurrence by 4% at 10 years. Breast cancers are sensitive to the dose per fraction, as shown by the results from four randomized trials which compared standard irradiation (50 Gy/25 fractions) with a hypofractionated scheme: no statistical difference was observed in locoregional recurrence and overall survival at 10 years...
June 2015: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Meena S Moran
This Review assesses the relevant data and controversies regarding the use of radiotherapy for, and locoregional management of, women with triple-negative breast cancer (TNBC). In view of the strong association between BRCA1 and TNBC, knowledge of baseline mutation status can be useful to guide locoregional treatment decisions. TNBC is not a contraindication for breast conservation therapy because data suggest increased locoregional recurrence risks (relative to luminal subtypes) with breast conservation therapy or mastectomy...
March 2015: Lancet Oncology
M Zemanova, K Rauova, E Boljesikova, K Machalekova, I Krajcovicova, V Lehotska, M Mikulova, J Svec
Breast angiosarcoma may occur de novo, or as a complication of radiation therapy, or chronic lymphedema secondary to axillary lymph node dissection for mammary carcinoma. Both primary and secondary angiosarcomas may present with bruise like skin discoloration, which may delay the diagnosis. Imaging findings are nonspecific. In case of high-grade tumours, MRI may be used effectively to determine lesion extent by showing rapid enhancement, nevertheless earliest possible diagnostics is crucial therefore any symptoms of angiosarcoma have to be carefully analysed...
2014: Bratislavské Lekárske Listy
E M Donovan, C Brooks, R A Mitchell, M Mukesh, C E Coles, P M Evans, E J Harris
AIMS: To determine the effect of image-guided radiotherapy on the dose distributions in breast boost treatments. MATERIALS AND METHODS: Computed tomography images from a cohort of 60 patients treated within the IMPORT HIGH trial (CRUK/06/003) were used to create sequential and concomitant boost treatment plans (30 cases each). Two treatment plans were created for each case using tumour bed planning target volume (PTV) margins of 5 mm (achieved with image-guided radiotherapy) and 8 mm (required for bony anatomy verification)...
November 2014: Clinical Oncology: a Journal of the Royal College of Radiologists
Moujhuri Nandi, Anurupa Mahata, Indranil Mallick, Rimpa Achari, Sanjoy Chatterjee
BACKGROUND: The standard radiotherapy (RT) fractionation practiced in India and worldwide is 50 Gy in 25 fractions over 5 weeks to the chest wall or whole breast followed by tumour bed boost in case of breast conservation (BCS). A body of validated data exists regarding hypofractionation in breast cancer. We here report initial results for 135 patients treated at our center with the START-B type of fractionation. MATERIALS AND METHODS: From May 2011 till July 2012, women with all stages of breast cancer (excluding metastatic), who had undergone BCS or mastectomy were planned for 40 Gy in 15 fractions over 3 weeks to chest wall/whole breast and supraclavicular fossa (where indicated) followed by tumour bed boost in BCS patients...
2014: Asian Pacific Journal of Cancer Prevention: APJCP
F Renoult, C Marchal, C Brunaud, V Harter, D Peiffert
PURPOSE: To evaluate the safety and efficacy of whole breast irradiation with a concomitant boost. PATIENTS AND MATERIALS: This is a retrospective study of 121 patients with node negative T1-T2 breast tumors inferior to 3 cm in diameter, previously treated by conservative surgery without chemotherapy. A dose of 50 Gy was delivered to the whole breast in 2 Gy daily fractions with 5 weekly treatments. A concomitant boost to the lumpectomy site delivered a total of 10 Gy in 1 Gy fractions twice a week...
June 2014: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
I Fragkandrea, V Kouloulias, P Mavridis, A Zettos, S Betsou, P Georgolopoulou, A Sotiropoulou, A Gouliamos, I Kouvaris
BACKGROUND: Hypofractionated Radiotherapy (RT) regimens for breast cancer, although reduce cost and time for patients and health care systems, could have a negative impact on normal underlying lung tissue. We studied and compared lung function and the post-RT radiological changes using High-Resolution Computed Tomography (HRCT) in early breast cancer patients, treated with 3-Dimentional conformal whole breast radiotherapy (WBRT) using either conventional or hypofractionated regime. PATIENTS AND METHODS: Between 2008 and 2009, 61 early breast cancer patients (T1-2N0M0) were randomised into two groups ...
July 2013: Hippokratia
Zaneta Wareńczak-Florczak, Andrzej Roszak, Krystyna Bratos, Piotr Milecki, Aldona Karczewska-Dzionk, Hanna Włodarczyk
AIM: The aim of this study was to assess the therapeutic effect of intraoperative radiotherapy, describe the method, and examine the occurrence of side effects and quality of life. 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...
2013: Reports of Practical Oncology and Radiotherapy
X Liem, C Chira, A Fourquet, F Campana, D Peurien, N Fournier-Bidoz, Y M Kirova
PURPOSE: To evaluate the dosimetry and acute toxicity of helical tomotherapy for locoregional irradiation of patients after breast-conserving surgery. PATIENTS AND METHODS: Twenty breast cancer patients with breast-conserving surgery treated by helical tomotherapy have been studied. The median age was 49 (min: 25, max: 69). The whole breast, tumour bed and lymph nodes were prescribed 52.2 Gy, 63.8 Gy and 50.4 Gy, all in 29 fractions. The dose per fraction was 2...
January 2014: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Grazia Tortorelli, Luana Di Murro, Rosaria Barbarino, Sara Cicchetti, Daniela di Cristino, Maria Daniela Falco, Dahlia Fedele, Gianluca Ingrosso, Dania Janniello, Pasquale Morelli, Alessandra Murgia, Elisabetta Ponti, Sara Terenzi, Barbara Tolu, Riccardo Santoni
BACKGROUND: To identify predictive factors of radiation-induced skin toxicity in breast cancer patients by the analysis of dosimetric and clinical factors. METHODS: 339 patients treated between January 2007 and December 2010 are included in the present analysis. Whole breast irradiation was delivered with Conventional Fractionation (CF) (50 Gy, 2.0/day, 25 fractions) and moderate Hypofractionated Schedule (HS) (44 Gy, 2.75 Gy/day, 16 fractions) followed by tumour bed boost...
2013: BMC Cancer
M-È Chand, S Rivera, C Hennequin, J-M Hannoun-Lévi, L Quero
For breast cancer, interstitial brachytherapy remains an accurate irradiation technique for delivering a high dose (increasing the local control) in a small volume (decreasing the toxicity). In this article, we present the technical data related to the breast brachytherapy proceeding, from the implantation of the vectors to the treatment itself, including the planning. The different indications of breast brachytherapy include all the breast irradiations focusing on the initial tumour bed (partial irradiation of the breast), such as boost, accelerated and partial breast irradiation (APBI) and second conservative radiosurgical treatment in case of ipsilateral in-breast recurrence...
April 2013: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
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