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https://www.readbyqxmd.com/read/28639030/utilization-of-hypofractionated-whole-breast-radiation-therapy-in-patients-receiving-chemotherapy-a-national-cancer-database-analysis
#1
Tejan P Diwanji, Jason K Molitoris, Arpit M Chhabra, James W Snider, Soren M Bentzen, Katherine H Tkaczuk, Paula Y Rosenblatt, Susan B Kesmodel, Emily C Bellavance, Randi J Cohen, Sally B Cheston, Elizabeth M Nichols, Steven J Feigenberg
PURPOSE: Results from four major hypofractionated whole-breast radiotherapy (HF-WBRT) trials have demonstrated equivalence in select patients with early-stage breast cancer when compared with conventionally fractionated WBRT (CF-WBRT). Because relatively little data were available on patients receiving neoadjuvant or adjuvant chemotherapy, consensus guidelines published in 2011 did not endorse the use of HF-WBRT in this population. Our goal is to evaluate trends in utilization of HF-WBRT in patients receiving chemotherapy...
June 21, 2017: Breast Cancer Research and Treatment
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
#2
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/28595775/surface-dose-measurements-in-and-out-of-field-implications-for-breast-radiotherapy-with-megavoltage-photon-beams
#3
Peta Lonski, Prabhakar Ramachandran, Rick Franich, Tomas Kron
This study examines the difference in surface dose between flat and flattening filter free (FFF) photon beams in the context of breast radiotherapy. The surface dose was measured for 6MV, 6MV FFF, 10MV, 10MV FFF and 18MV photon beams using a thin window ionisation chamber for various field sizes. Profiles were acquired to ascertain the change in surface dose off-axis. Out-of-field measurements were included in a clinically representative half beam block tangential breast field. In the field centres of FFF beams the surface dose was found to be increased for small fields and decreased for large fields compared to flat beams...
June 5, 2017: Zeitschrift Für Medizinische Physik
https://www.readbyqxmd.com/read/28559768/intraoperative-radiotherapy-of-breast-cancer-and-its-biological-effects
#4
REVIEW
Igor Piotrowski, Katarzyna Kulcenty, Mateusz Wichtowski, Dawid Murawa, Wiktoria Suchorska
Conservative breast cancer surgery followed by radiation therapy is the standard treatment for this type of cancer. Numerous studies demonstrate that 90% of local recurrences after traditional surgery occur in the same quadrant as the primary cancer. The published data suggest that the wound healing process after surgery alters the area surrounding the original tumor and the modified microenvironment is more favorable for the tumor to recur. The majority of metastases within scar initiated much research, and the consequences of these studies led to clinical trials aimed at assessing whether localized radiotherapy, such as intraoperative radiotherapy (IORT), would be more effective in inhibiting formation of local recurrence than the standard postoperative whole breast radiotherapy...
May 2017: Breast Care
https://www.readbyqxmd.com/read/28559459/tamoxifen-acceptance-and-adherence-among-patients-with-ductal-carcinoma-in-situ-dcis-treated-in-a-multidisciplinary-setting
#5
Lindsey C Karavites, Anna K Kane, Shruti Zaveri, Yanfei Xu, Irene Helenowski, Nora Hansen, Kevin P Bethke, Laura J Rasmussen-Torvik, Seema A Khan
Tamoxifen and other endocrine agents have proven benefits for women with ductal carcinoma in situ (DCIS) but low patient acceptance is widely reported. We examined factors associated with tamoxifen acceptance and adherence among DCIS patients who received a recommendation for therapy in a multidisciplinary setting. <p>Using our institutional database, we identified women diagnosed with DCIS, 1998-2009 who were offered tamoxifen. We recorded data on demographics, tumor and therapy variables, tamoxifen acceptance, and adherence to therapy for > 4 years...
May 30, 2017: Cancer Prevention Research
https://www.readbyqxmd.com/read/28556781/supine-mri-for-regional-breast-radiotherapy-imaging-axillary-lymph-nodes-before-and-after-sentinel-node-biopsy
#6
Tristan C F van Heijst, Debora Eschbach-Zandbergen, Nienke Hoekstra, Bram van Asselen, Jan Lagendijk, Helena Verkooijen, Ruud Pijnappel, Stephanie de Waard, Arjen Witkamp, Thijs van Dalen, H J G van den Bongard, Marielle Philippens
Regional radiotherapy (RT) is increasingly used in breast-cancer treatment. Conventionally, computed tomography (CT) is performed for RT planning. Lymph node (LN) target levels are delineated according to anatomical boundaries. MRI could enable individual LN delineation. The purpose was to evaluate applicability of MRI for LN detection in supine treatment position, before and after sentinel-node biopsy (SNB). 23 female breast-cancer patients (cTis-3N0M0) underwent 1.5T MRI, before and after SNB, additional to CT...
May 30, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28466122/objective-breast-symmetry-analysis-with-the-breast-analyzing-tool-bat-improved-tool-for-clinical-trials
#7
Wilfried Krois, Alexander Ken Romar, Thomas Wild, Peter Dubsky, Ruth Exner, Peter Panhofer, Raimund Jakesz, Michael Gnant, Florian Fitzal
PURPOSE: Objective cosmetic analysis is important to evaluate the cosmetic outcome after breast surgery or breast radiotherapy. For this purpose, we aimed to improve our recently developed objective scoring software, the Breast Analyzing Tool (BAT(®)). METHODS: A questionnaire about important factors for breast symmetry was handed out to ten experts (surgeons) and eight non-experts (students). Using these factors, the first-generation BAT(®) software formula has been modified and the breast symmetry index (BSI) from 129 women after breast surgery has been calculated by the first author with this new BAT(®) formula...
May 2, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28432730/assessment-of-voluntary-deep-inspiration-breath-hold-with-cine-imaging-for-breast-radiotherapy
#8
Reuben Patrick Estoesta, Lani Attwood, Diana Naehrig, Elizabeth Claridge-Mackonis, David Odgers, Darren Martin, Melissa Pham, Joanne Toohey, Susan Carroll
Deep Inspiration Breath-Hold (DIBH) techniques for breast cancer radiation therapy (RT) have reduced cardiac dose compared to Free Breathing (FB). Recently, a voluntary deep inspiration breath-hold (vDIBH) technique was established using in-room lasers and skin tattoos to monitor breath-hold. An in-house quality assessment of positional reproducibility during RT delivery with vDIBH in patients with left-sided breast cancer was evaluated. The electronic portal imaging device (EPID) was used in cinematographic (CINE) mode to capture a sequence of images during beam delivery...
April 22, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28427525/precision-medicine-for-early-breast-cancer-radiotherapy-opening-up-new-horizons
#9
REVIEW
Jacques Bernier
So far most efforts put forth to test the value of predictive and prognostic tools in the field of breast radiotherapy remained globally disappointing, or at least below the convincing levels reached for systemic therapy. Nevertheless the addition of predictive tools to the clinical armament tends to prevail over the use of the sole prognostic factors, also in radiotherapy. A number of predictive assays, clinically validated or not, have recently elicited significant associations between molecular profiles and tumor biological aggressiveness and/or radiosensitivity levels...
May 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28392704/predictive-parameters-in-hypofractionated-whole-breast-3d-conformal-radiotherapy-according-to-the-ontario-canadian-trial
#10
Grazia Lazzari, Angela Terlizzi, Giuseppina Della Vittoria Scarpati, Francesco Perri, Vincenzo De Chiara, Barbara Turi, Giovanni Silvano
AIM: To evaluate the possible role of dosimetric parameters according Normal Tissue Complication Probability (NTCP) model as predictive of late toxicity and cosmesis in hypofractionated whole-breast three-dimensional conformal radiotherapy. PATIENTS AND METHODS: A retrospective analysis on 215 consecutive early breast cancer patients treated with breast conserving surgery and adjuvant hypofractionated whole-breast radiotherapy (according the Ontario Canadian trial), with a 6 years median follow-up was conducted...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28358936/association-of-radiotherapy-boost-for-ductal-carcinoma-in-situ-with-local-control-after-whole-breast-radiotherapy
#11
Meena S Moran, Yinjun Zhao, Shuangge Ma, Youlia Kirova, Alain Fourquet, Peter Chen, Karen Hoffman, Kelly Hunt, Julia Wong, Lia M Halasz, Gary Freedman, Robert Prosnitz, Michael Yassa, David H A Nguyen, Tarek Hijal, Bruce G Haffty, Elaine S Wai, Pauline T Truong
Importance: The use of a radiotherapy (RT) boost to the tumor bed after whole-breast RT (WBRT) for ductal carcinoma in situ (DCIS) is largely extrapolated from invasive cancer data, but robust evidence specific to DCIS is lacking. Objective: To compare ipsilateral breast tumor recurrence (IBTR) in women with DCIS treated with vs without the RT boost after breast-conserving surgery and WBRT. Design, Setting, and Participants: This retrospective analysis pooled deidentified patient-level data from 10 academic institutions in the United States, Canada, and France from January 1, 1980, through December 31, 2010...
March 30, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28343538/accelerated-hypofractionated-adjuvant-whole-breast-radiation-with-simultaneous-integrated-boost-using-volumetric-modulated-arc-therapy-for-early-breast-cancer-a-phase-i-ii-dosimetric-and-clinical-feasibility-study-from-a-tertiary-cancer-care-centre-of-india
#12
Dodul Mondal, Pramod Kumar Julka, Daya Nand Sharma, Manisha Jana, Macharla Anjaneyelu Laviraj, Suryanarayan Vs Deo, Soumyajit Roy, Randeep Guleria, Goura K Rath
BACKGROUND: Hypofractionation has become standard of care after Breast Conserving Therapy (BCT) in many European and few others western countries. Though still debatable, tumor cavity boost is routinely practised in our centre. Hypofractionation is not yet the current standard of practice in Asian countries. Employing hypofractionation and simultaneous integrated boost to lumpectomy cavity with conformal technique is not the current practice in this region. Hence the study was performed to see whether accelerated hypofractionation and simultaneous boost can be combined using volumetric modulated arc therapy (VMAT) in treating early breast cancer (EBC) patients...
March 2017: Journal of the Egyptian National Cancer Institute
https://www.readbyqxmd.com/read/28325619/effects-of-online-cone-beam-computed-tomography-with-active-breath-control-in-determining-planning-target-volume-during-accelerated-partial-breast-irradiation
#13
Y Li, R Zhong, X Wang, P Ai, F Henderson, N Chen, F Luo
PURPOSE: To test if active breath control during cone-beam computed tomography (CBCT) could improve planning target volume during accelerated partial breast radiotherapy for breast cancer. METHODS: Patients who were more than 40 years old, underwent breast-conserving dissection and planned for accelerated partial breast irradiation, and with postoperative staging limited to T1-2 N0 M0, or postoperative staging T2 lesion no larger than 3cm with a negative surgical margin greater than 2mm were enrolled...
April 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/28320428/a-topology-based-method-to-mitigate-the-dosimetric-uncertainty-caused-by-the-positional-variation-of-the-boost-volume-in-breast-conservative-radiotherapy
#14
Peng-Yi Lee, Chih-Yuan Lin, Shang-Wen Chen, Chun-Ru Chien, Chun-Nan Chu, Hsiu-Ting Hsu, Ji-An Liang, Ying-Jun Lin, An-Cheng Shiau
BACKGROUND: To improve local control rate in patients with breast cancer receiving adjuvant radiotherapy after breast conservative surgery, additional boost dose to the tumor bed could be delivered simultaneously via the simultaneous integrated boost (SIB) modulated technique. However, the position of tumor bed kept changing during the treatment course as the treatment position was aligned to bony anatomy. This study aimed to analyze the positional uncertainties between bony anatomy and tumor bed, and a topology-based approach was derived to stratify patients with high variation in tumor bed localization...
March 20, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28300372/lung-volume-reproducibility-under-abc-control-and-self-sustained-breath-holding
#15
Evangelia Kaza, Alex Dunlop, Rafal Panek, David J Collins, Matthew Orton, Richard Symonds-Tayler, Dualta McQuaid, Erica Scurr, Vibeke Hansen, Martin O Leach
An Active Breathing Coordinator (ABC) can be employed to induce breath-holds during CT imaging and radiotherapy of lung, breast and liver cancer, and recently during lung cancer MRI. The apparatus measures and controls respiratory volume, hence subject lung volume reproducibility is its principal measure of effectiveness. To assess ABC control quality, the intra-session reproducibility of ABC-induced lung volumes was evaluated and compared with that reached by applying the clinical standard of operator-guided self-sustained breath-holds on healthy volunteers during MRI...
March 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28297275/how-dose-sparing-of-cardiac-structures-correlates-with-in-field-heart-volume-and-sternal-displacement
#16
Taeho Kim, Kelli Reardon, Daniel M Trifiletti, Constance Geesey, Kaitlyn Sukovich, Edwin Crandley, Paul W Read, Krishni Wijesooriya
Cardiac irradiation increases the risk of coronary artery disease in patients with left-sided breast cancer. Techniques exist to reduce cardiac irradiation, but the optimum technique depends on individual patient anatomy and physiology. We investigated the correlation of delta heart volume in field (dHVIF) and sternal excursion with dose sparing in heart and left anterior descending artery (LAD) to develop quantitative predictive models for expected dose to heart and LAD. A treatment planning study was performed on 97 left-breast cancer patients who underwent whole breast radiotherapy (prescription dose = 50 Gy) under deep inspiratory breath hold (DIBH)...
November 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28296326/evaluation-of-target-and-cardiac-position-during-visually-monitored-deep-inspiration-breath-hold-for-breast-radiotherapy
#17
Leigh Conroy, Rosanna Yeung, Elizabeth Watt, Sarah Quirk, Karen Long, Alana Hudson, Tien Phan, Wendy L Smith
A low-resource visually monitored deep inspiration breath-hold (VM-DIBH) technique was successfully implemented in our clinic to reduce cardiac dose in left-sided breast radiotherapy. In this study, we retrospectively characterized the chest wall and heart positioning accuracy of VM-DIBH using cine portal images from 42 patients. Central chest wall position from field edge and in-field maximum heart distance (MHD) were manually measured on cine images and compared to the planned positions based on the digitally reconstructed radiographs (DRRs)...
July 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28291912/improving-the-efficiency-of-breast-radiotherapy-treatment-planning-using-a-semi-automated-approach
#18
Robert A Mitchell, Philip Wai, Ruth Colgan, Anna M Kirby, Ellen M Donovan
OBJECTIVES: To reduce treatment planning times while maintaining plan quality through the introduction of semi-automated planning techniques for breast radiotherapy. METHODS: Automatic critical structure delineation was examined using the Smart Probabilistic Image Contouring Engine (SPICE) commercial autosegmentation software (Philips Radiation Oncology Systems, Fitchburg, WI) for a cohort of ten patients. Semiautomated planning was investigated by employing scripting in the treatment planning system to automate segment creation for breast step-and-shoot planning and create objectives for segment weight optimization; considerations were made for three different multileaf collimator (MLC) configurations...
January 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28243923/risks-and-benefits-of-reducing-target-volume-margins-in-breast-tangent-radiotherapy
#19
Deepak Basaula, Alexandra Quinn, Amy Walker, Vikneswary Batumalai, Shivani Kumar, Geoff P Delaney, Lois Holloway
This study investigates the potential benefits of planning target volume (PTV) margin reduction for whole breast radiotherapy in relation to dose received by organs at risk (OARs), as well as reductions in radiation-induced secondary cancer risk. Such benefits were compared to the increased radiation-induced secondary cancer risk attributed from increased ionizing radiation imaging doses. Ten retrospective patients' computed tomography datasets were considered. Three computerized treatment plans with varied PTV margins (0, 5 and 10 mm) were created for each patient complying with the Radiation Therapy Oncology Group (RTOG) 1005 protocol requirements...
February 27, 2017: Australasian Physical & Engineering Sciences in Medicine
https://www.readbyqxmd.com/read/28236538/understanding-variations-in-the-use-of-hypofractionated-radiotherapy-and-its-specific-indications-for-breast-cancer-a-mixed-methods-study
#20
Joan Prades, Manel Algara, Josep A Espinàs, Blanca Farrús, Meritxell Arenas, Victoria Reyes, Virginia García-Reglero, Maria Josep Cambra, Esther Rubio, Lluis Anglada, Arantxa Eraso, Agustí Pedro, Maria J Fuentes-Raspall, Victòria Tuset, Judit Solà, Josep M Borras
BACKGROUND AND PURPOSE: Radiation oncology guidelines favour hypofractionated whole-breast radiotherapy (HWBRT) over more conventional schemes in the conservative treatment of breast cancer, but its adoption still varies in clinical practice. This study assessed the patterns of HWBRT adoption in Catalonia (Spain). MATERIAL AND METHODS: We used a mixed-methods approach based on an explanatory sequential design, first collecting and analysing quantitative data on HWBRT use (>2...
April 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
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