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"breast radiotherapy"

Vikneswary Batumalai, Penny Phan, Callie Choong, Lois Holloway, Geoff P Delaney
INTRODUCTION: To compare the differences in setup errors measured with electronic portal image (EPI) and cone-beam computed tomography (CBCT) in patients undergoing tangential breast radiotherapy (RT). Relationship between setup errors, body mass index (BMI) and breast size was assessed. METHODS: Twenty-five patients undergoing postoperative RT to the breast were consented for this study. Weekly CBCT scans were acquired and retrospectively registered to the planning CT in three dimensions, first using bony anatomy for bony registration (CBCT-B) and again using breast tissue outline for soft tissue registration (CBCT-S)...
May 31, 2016: Journal of Medical Radiation Sciences
Jenna Dean, Carmen J Hansen, Justin Westhuyzen, Brett Waller, Kirsty Turnbull, Maree Wood, Andrew Last
INTRODUCTION: Inverse-planned intensity modulated radiation therapy (IP-IMRT) has potential benefits over other techniques for tangential intact breast radiotherapy. Possible benefits include increased homogeneity, faster planning time, less inter-planner variability and lower doses to organs at risk (OAR). We therefore conducted a pilot study of previously treated intact breast patients to compare the current forward-planned 'field-in-field' technique (FP-IMRT) with an IP-IMRT alternative...
July 18, 2016: Journal of Medical Radiation Sciences
Luciana Lastrucci, Simona Borghesi, Silvia Bertocci, Chiara Gasperi, Andrea Rampini, Giovanna Buonfrate, Paola Pernici, Roberta De Majo, Pietro Giovanni Gennari
PURPOSE: To compare 3D-conformal radiotherapy (3D-CRT) treatment plans based on free-breathing (FB) and deep inspiration breath hold (DIBH) and investigated whether DIBH technique enables a decrease of cardiac left anterior descending coronary artery (LADCA) and lungs dose with respect to the FB. METHODS: Twenty-three left-sided breast cancer patients referred for breast radiotherapy were included. The planning target volume (PTV) encompassed the breast and organs at risk including heart, LADCA, lungs, and contralateral breast, which were contoured in FB and DIBH CT scans...
September 27, 2016: Tumori
Steven J Landeg, Anna M Kirby, Steven F Lee, Freddie Bartlett, Kumud Titmarsh, Ellen Donovan, Clare L Griffin, Lone Gothard, Imogen Locke, Helen A McNair
OBJECTIVES: The purpose of this UK study was to evaluate inter-fraction reproducibility and body image score when using Ultraviolet (UV) tattoos (not visible in ambient lighting) for external references during breast/chest wall radiotherapy and compare to conventional dark ink. METHODS: In this non-blinded, single centre, parallel group, randomised control trial, patients were allocated 1:1 to receive either conventional dark ink or UV ink tattoos using computer generated random blocks...
October 6, 2016: British Journal of Radiology
Juan-Francisco Calvo-Ortega, Sandra Moragues, Miquel Pozo, Joan Casals
AIM: To investigate the viability of placing the treatment isocenter at the patient midline for breast cancer radiotherapy in order to avoid the risk of collisions during image-guided setup and treatment delivery. BACKGROUND: The use of kilovoltage orthogonal setup images has spread in last years in breast radiotherapy. There is a potential risk of an imaging system-patient collision when the isocenter is laterally placed. MATERIALS AND METHODS: Twenty IMRT plans designed by placing the isocenter within the breast volume ("plan_ref"), were retrospectively replanned by shifting the isocenter at the patient's midline ("plan_off-breast")...
November 2016: Reports of Practical Oncology and Radiotherapy
Kana Takahashi, Madoka Morota, Yoshikazu Kagami, Hiroyuki Okamoto, Shuhei Sekii, Koji Inaba, Naoya Murakami, Hiroshi Igaki, Yoshinori Ito, Takashi Uno, Jun Itami
BACKGROUND: This prospective study aimed to compare dose volume histograms (DVH) of the breasts and organs at risk (OARs) of whole breast radiotherapy in the supine and prone positions, and frequency and severity of acute and late toxicities were analyzed. METHODS: Early-stage breast cancer patients with large breasts (Japanese bra size C or larger, or the widest measurements of the bust ≥ 95 cm) undergoing partial mastectomy participated in this study. CT-based treatment plans were made in each position, and various dosimetric parameters for the breast and OARs were calculated to compare the supine and prone radiotherapy plans...
September 29, 2016: BMC Cancer
Joanne S Haviland, Søren M Bentzen, Judith M Bliss, John R Yarnold
BACKGROUND: Tests of tumour treatment time effect in patients prescribed post-operative radiotherapy for early breast cancer have focussed on time to start of radiotherapy rather than overall treatment time. The START randomised trials of radiotherapy fractionation provide an opportunity to directly estimate the effect of treatment acceleration. METHODS: Between 1986 and 2002, a total of 5861 women with early breast cancer were recruited into the UK START pilot (START-P), START-A and START-B randomised trials...
September 22, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
A Cabanne, U Schick, O Pradier, S Rivera
The benefit of postoperative radiotherapy for breast cancer both in terms of local control and overall survival is widely acknowledged. Today, technological advances in simulation imaging and positioning control enable the definition of new margins from CTV to PTV. Improvements in mathematical modeling of random and systematic errors impact the treatment plans. However, there is no universal absolute value to consistently determine the margins from CTV to PTV. It is down to each centre to assess and correct as much as possible uncertainties due to positioning and internal movements depending on techniques and methods used for the implementation of treatment and monitoring...
October 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
M Aumont
Breast-conserving surgery followed by whole breast postoperative irradiation is considered to be the current standard treatment for patients with early stage breast cancer. It allows an excellent local tumour control with 6% of local recurrence. Over the last years, partial breast radiotherapy has been developed to reduce treatment volume and duration. Intraoperative radiotherapy is one of the techniques. It offers an excellent delineation of the tumour bed and high normal tissue sparing. This purpose of this review is to describe the different intraoperative radiotherapy techniques available, to assess their potential clinical efficiency and tolerance, the recommendations for new practice with a selected population of patients and for future research...
October 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Laurie W Cuttino, Charlotte Dai Kubicky
No abstract text is available yet for this article.
September 8, 2016: JAMA Oncology
Michał Falco, Bartłomiej Masojć, Magdalena Rolla, Agnieszka Czekała, Jolanta Pietruszewska, Agnieszka Rubik-Leszczyńska, Mirosław Lewocki, Magdalena Łukowiak, Andrzej Kram
BACKGROUND: Novel techniques in oncology provide new treatment opportunities but also introduce different patterns of side effects. Intraoperative radiotherapy (IORT) allows a shortened overall treatment time for early breast cancer either combined with whole breast radiotherapy (WBRT), or alone. Although the early side effects of IORT are well known, data on clinically important late side effects, which require medical intervention, are scarce. AIM: In this study, we analyze risk factors for seroma evacuation more than 6 months after IORT...
May 2016: Reports of Practical Oncology and Radiotherapy
A Mège, A Ziouèche-Mottet, V Bodez, R Garcia, A Arnaud, G de Rauglaudre, N Pourel, B Chauvet
Adjuvant radiation therapy following breast cancer surgery continues to improve locoregional control and overall survival. But the success of highly targeted-conformal radiotherapy such as intensity-modulated techniques, can be compromised by respiratory motion. The intrafraction motion can potentially result in significant under- or overdose, and also expose organs at risk. This article summarizes the respiratory motion and its effects on imaging, dose calculation and dose delivery by radiotherapy for breast cancer...
October 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Nicolle Dunkerley, Frederick R Bartlett, Anna M Kirby, Philip M Evans, Ellen M Donovan
OBJECTIVES: The purpose of the work was to estimate the dose received by the heart throughout a course of breath holding breast radiotherapy. METHODS: 113 cone beam CT (CBCT) scans were acquired for 20 patients treated within the HeartSpare 1A study in which both an Active Breathing Control (ABC) device and a voluntary breath hold method (VBH) were used. Predicted mean heart doses were obtained from treatment plans. CBCT scans were imported into a treatment planning system, heart outlines defined, images registered to the CT planning scan and mean heart dose recorded...
August 31, 2016: British Journal of Radiology
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
G Lee, R Dinniwell, F F Liu, A Fyles, K Han, T Conrad, W Levin, A Marshall, T G Purdie, C A Koch
AIMS: Breast radiotherapy treatment is commonly managed by a multidisciplinary team to ensure optimal delivery of care. We sought a new model of care whereby a clinical specialist radiation therapist (CSRT) delineates the cavity target for whole breast radiotherapy treatment planning and the radiation oncologist validates the contour during final plan review. This study evaluated the radiation oncologist's acceptance of these contours and identified characteristics of cavities suitable for CSRT-directed contouring...
August 16, 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
Allison Lipitz-Snyderman, Camelia S Sima, Coral L Atoria, Elena B Elkin, Christopher Anderson, Victoria Blinder, Chiaojung Jillian Tsai, Katherine S Panageas, Peter B Bach
Importance: Interventions to address overuse of health care services may help reduce costs and improve care. Understanding physician-level variation and behavior patterns can inform such interventions. Objective: To assess patterns of physician ordering of services that tend to be overused in the treatment of patients with cancer. We hypothesized that physicians exhibit consistent behavior. Design, Setting, and Participants: Retrospective study of patients 66 years and older diagnosed with cancer between 2004 and 2011, using population-based Surveillance, Epidemiology, and End Results (SEER)-Medicare data to assess physician-level variation in 5 nonrecommended services...
October 1, 2016: JAMA Internal Medicine
M Luke Marinovich, Lamiae Azizi, Petra Macaskill, Les Irwig, Monica Morrow, Lawrence J Solin, Nehmat Houssami
PURPOSE: There is no consensus on adequate negative margins in breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS). We systematically reviewed the evidence on margins in BCS for DCIS. METHODS: A study-level meta-analysis of local recurrence (LR), microscopic margin status and threshold distance for negative margins. LR proportion was modeled using random-effects logistic meta-regression (frequentist) and network meta-analysis (Bayesian) that allows for multiple margin distances per study, adjusting for follow-up time...
November 2016: Annals of Surgical Oncology
Jinhong Jung, Moonkyoo Kong, Su Ssan Kim, Won Sup Yoon
Introduction. To evaluate the dose distribution and coverage of axilla using only tangential field for whole breast radiotherapy (RT) at three institutions in Korea. Methods. We used computed tomography (CT) images of nine consecutive 1-2 sentinel lymph node-positive patients who underwent breast conserving surgery and whole breast RT without axillary lymph node (ALN) dissection for clinical T1-2N0 breast cancer. The CT data were transferred to three radiation oncologists in 3 institutions and each radiation oncologist created treatment plans for all nine patients; a total of 27 treatment plans were analyzed...
2016: International Journal of Breast Cancer
Waseem Raza, Sushma Agarwal, Koilpillai Joseph Maria Das, Sellepolyam Kaliyaperumal Senthil Kumar, Punita Lal
AIM: To quantify and compare setup errors between small and large breast patients undergoing intact breast radiotherapy. METHODS: 20 patients were inducted. 10 small/moderate size breast in arm I and 10 large breast in arm II. Two orthogonal and one lateral tangent portal images (PIs) were obtained and analyzed for systematic (Σ) and random (σ) errors. Effect of no action level (NAL) was also evaluated retrospectively. RESULTS: 142 PIs were analyzed...
September 2016: Reports of Practical Oncology and Radiotherapy
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
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