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"breast radiotherapy"

David M Edmunds, Lone Gothard, Komel Khabra, Anna Kirby, Poonam Madhale, Helen McNair, David Roberts, K K Tang, Richard Symonds-Tayler, Fatemeh Tahavori, Kevin Wells, Ellen Donovan
Voluntary inspiration breath hold (VIBH) for left breast cancer patients has been shown to be a safe and effective method of reducing radiation dose to the heart. Currently, VIBH protocol compliance is monitored visually. In this work, we establish whether it is possible to gate the delivery of radiation from an Elekta linac using the Microsoft Kinect version 2 (Kinect v2) depth sensor to measure a patient breathing signal. This would allow contactless monitoring during VMAT treatment, as an alternative to equipment-assisted methods such as active breathing control (ABC)...
March 13, 2018: Journal of Applied Clinical Medical Physics
Alex C Herskovic, Xian Wu, Paul J Christos, Himanshu Nagar
PURPOSE: We used the National Cancer Data Base to analyze practice patterns of adjuvant breast radiotherapy (RT) in elderly patients to see if a difference in overall survival (OS) could be detected. Additionally, we investigated factors that affected OS in these patients. PATIENTS AND METHODS: Women aged ≥ 65 years with hormone receptor-positive and human epidermal growth factor receptor 2 (HER2)-negative pathologic T1-T2N0M0 invasive breast cancer measuring up to 3 cm who were treated with breast conservation and adjuvant endocrine therapy without adjuvant chemotherapy were identified and stratified by use of adjuvant RT...
February 20, 2018: Clinical Breast Cancer
Heather T Gold, Dawn Walter, Eleni Tousimis, Mary Katherine Hayes
A new breast cancer treatment, brachytherapy-based accelerated partial breast radiotherapy (RT), was adopted before long-term effectiveness evidence, potentially increasing morbidity and costs compared with whole breast RT. The aim of this study was to estimate complication rates and RT-specific and 1-year costs for a cohort of female Medicare beneficiaries diagnosed with breast cancer (N = 47 969). We analyzed 2005-2007 Medicare claims using multivariable logistic regression for complications and generalized linear models (log link, gamma distribution) for costs...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
A Ranger, A Dunlop, K Hutchinson, H Convery, M K Maclennan, H Chantler, N Twyman, C Rose, D McQuaid, R A Amos, C Griffin, N M deSouza, E Donovan, E Harris, C E Coles, A Kirby
AIMS: Radiotherapy target volumes in early breast cancer treatment increasingly include the internal mammary chain (IMC). In order to maximise survival benefits of IMC radiotherapy, doses to the heart and lung should be minimised. This dosimetry study compared the ability of three-dimensional conformal radiotherapy, arc therapy and proton beam therapy (PBT) techniques with and without breath-hold to achieve target volume constraints while minimising dose to organs at risk (OARs). MATERIALS AND METHODS: In 14 patients' datasets, seven IMC radiotherapy techniques were compared: wide tangent (WT) three-dimensional conformal radiotherapy, volumetric-modulated arc therapy (VMAT) and PBT, each in voluntary deep inspiratory breath-hold (vDIBH) and free breathing (FB), and tomotherapy in FB only...
February 23, 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
Narek Shaverdian, Xiaoyan Wang, John V Hegde, Criselda Aledia, Joanne B Weidhaas, Michael L Steinberg, Susan A McCloskey
BACKGROUND: Although the efficacy and toxicity of breast radiotherapy (RT) has been studied extensively, to the authors' knowledge little is known regarding the patient's perspective on the modern breast RT experience. To better inform future patients and providers, the authors explored patient perceptions of their RT experience. METHODS: Consecutive patients who were free of disease recurrence and who had been treated between 2012 and 2016 were surveyed regarding their original fears, how short-term and long-term toxicities compared with initial expectations, and how pretreatment beliefs concerning RT compared with the actual experience...
February 26, 2018: Cancer
Leonard Christopher Schmeel, David Koch, Sabina Stumpf, Christina Leitzen, Birgit Simon, Heinrich Schüller, Susanne Vornholt, Felix Schoroth, Thomas Müdder, Fred Röhner, Stephan Garbe, Frederic Carsten Schmeel, Hans Heinz Schild, Timo Martin Wilhelm-Buchstab
PURPOSE: Radiation-induced skin injury represents one of the most common side effects in breast cancer patients receiving adjuvant whole-breast radiotherapy. Numerous systemic and topical treatments have been studied in the prevention and management of radiation-induced skin injury without providing sustainable treatment strategies. While superficial barrier-forming skin products such as dressings are the standard of care in wound care management, their utilization as preventive treatment approach in radiotherapy has barely attracted attention...
February 20, 2018: Acta Oncologica
Joshua R Niska, Sameer R Keole, Barbara A Pockaj, Michele Y Halyard, Samir H Patel, Donald W Northfelt, Richard J Gray, Nabil Wasif, Carlos E Vargas, William W Wong
Background: Recent trials in early-stage breast cancer support hypofractionated whole-breast radiotherapy (WBRT) as part of breast-conserving therapy (BCT). Evidence also suggests that radiotherapy (RT) omission may be reasonable for some patients over 70 years. Among radiation-delivery techniques, intensity-modulated RT (IMRT) is more expensive than 3-dimensional conformal RT (3DCRT). Based on this evidence, in 2013, the American Society for Radiation Oncology (ASTRO) recommended hypofractionated schedules for women aged ≥50 years with early-stage breast cancer and avoiding routine use of IMRT for WBRT...
2018: Breast Cancer: Targets and Therapy
Hui Lin, Tianyu Liu, Chengyu Shi, Saskia Petillion, Isabelle Kindts, Caroline Weltens, Tom Depuydt, Yulin Song, Ziad Saleh, Xie George Xu, Xiaoli Tang
The deep inspiration breath hold (DIBH) and prone (P) position are two common heart-sparing techniques for external-beam radiation treatment of left-sided breast cancer patients. Clinicians select the position that is deemed to be better for tissue sparing based on their experience. This approach, however, is not always optimum and consistent. In response to this, we develop a quantitative tool that predicts the optimal positioning for the sake of organs at risk (OAR) sparing. Sixteen left-sided breast cancer patients were considered in the study, each received CT scans in the supine free breathing, supine DIBH, and prone positions...
February 13, 2018: Journal of Applied Clinical Medical Physics
Emanuela Esposito, Michael Douek
Intraoperative radiotherapy (IORT) for breast cancer has challenged the standard external beam radiotherapy (EBRT) and has been shown to be non-inferior for treating early breast cancer in the past decade. Several technologies have been tested for IORT and various randomised controlled trials are still ongoing. Different methods of application of IORT have also been evaluated, from early breast cancer to tumour bed boost radiotherapy amongst high risk women. TARGIT-A and ELIOT trials have reported a low incidence of local recurrence and good survival in both arms...
2018: Ecancermedicalscience
Hisashi Sato, Junko Ebi, Tomoaki Tamaki, Ami Yukawa, Masaru Nakajima, Tohru Ohtake, Yoshiyuki Suzuki
Radiation-induced organizing pneumonia (OP) reportedly occurs in ~2% of patients who receive whole-breast radiotherapy (WBRT). Though there are several reported risk factors, they remain unclear and controversial. We analyzed the incidence of and risk factors for OP after WBRT at our institution. We analyzed 665 breast cancer patients (with WBRT of 679 breasts) who underwent WBRT from October 2007 to September 2012 at our institution and were followed up for more than 1 year after completion of WBRT. Factors included in the analysis were age, the side affected, central lung distance (CLD), radiation dose, concurrent endocrine therapy, and chemotherapy...
February 3, 2018: Journal of Radiation Research
Ana Cravo Sá, Ana Fermento, Dalila Neves, Sara Ferreira, Teresa Silva, Carina Marques Coelho, Aude Vaandering, Ana Roma, Sérgio Quaresma, Emmanuel Bonnarens
Aim: In this study, we intend to compare two different setup procedures for female breast cancer patients. Background: Imaging in radiotherapy provides a precise localization of the tumour, increasing the accuracy of the treatment delivery in breast cancer. Materials and methods: Twenty breast cancer patients who underwent whole breast radiotherapy (WBRT) were selected for this study. Patients were divided into two groups of ten. Group one (G1) was positioned by tattoos and then the patient positioning was adjusted with the aid of AlignRT (Vision RT, London, UK)...
January 2018: Reports of Practical Oncology and Radiotherapy
Zsuzsanna Kahán, Ferenc Rárosi, Szilvia Gaál, Adrienn Cserháti, Krisztina Boda, Barbara Darázs, Renáta Kószó, Ferenc Lakosi, Ákos Gulybán, Philippe A Coucke, Zoltán Varga
BACKGROUND AND PURPOSE: The benefit of reduced radiation heart exposure in the prone vs. supine position individually differs. In this prospective cohort study, the goal was to develop a simple method for the operation of a validated model for the prediction of preferable treatment position during left breast radiotherapy. MATERIAL AND METHODS: In 100 cases, a single CT slice was utilized for the collection of the needed patient-specific data (in addition to body mass index, the distance of the LAD from the chest wall and the area of the heart included in the radiation fields at the middle of the heart in the supine position)...
January 17, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
I S Bhattacharya, A M Kirby, J M Bliss, C E Coles
Adjuvant radiotherapy after breast-conserving surgery has been an important component of the standard of care for early breast cancer. Improvements in breast cancer care have resulted in a substantial reduction in local relapse rates over recent decades. Although the proportional benefits of adjuvant radiotherapy are similar for different prognostic risk groups of patients, the absolute benefits depend on the risk of relapse and therefore vary considerably between prognostic groups. Radiotherapy is not without risk and for some patients at very low risk of relapse the risks of radiotherapy may outweigh the benefit, leading to potential overtreatment...
January 10, 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
Clare Snyder, Brian W Pogue, Michael Jermyn, Irwin Tendler, Jacqueline M Andreozzi, Petr Bruza, Venkat Krishnaswamy, David J Gladstone, Lesley A Jarvis
Imaging of Cherenkov light emission from patient tissue during fractionated radiotherapy has been shown to be a possible way to visualize beam delivery in real time. If this tool is advanced as a delivery verification methodology, then a sequence of image processing steps must be established to maximize accurate recovery of beam edges. This was analyzed and developed here, focusing on the noise characteristics and representative images from both phantoms and patients undergoing whole breast radiotherapy. The processing included temporally integrating video data into a single, composite summary image at each control point...
January 2018: Journal of Medical Imaging
Chamberlain Mbah, Kim De Ruyck, Silke De Schrijver, Charlotte De Sutter, Kimberly Schiettecatte, Chris Monten, Leen Paelinck, Wilfried De Neve, Hubert Thierens, Catharine West, Gustavo Amorim, Olivier Thas, Liv Veldeman
INTRODUCTION: Evaluation of patient characteristics inducing toxicity in breast radiotherapy, using simultaneous modeling of multiple endpoints. METHODS AND MATERIALS: In 269 early-stage breast cancer patients treated with whole-breast irradiation (WBI) after breast-conserving surgery, toxicity was scored, based on five dichotomized endpoints. Five logistic regression models were fitted, one for each endpoint and the effect sizes of all variables were estimated using maximum likelihood (MLE)...
January 4, 2018: Acta Oncologica
Hans-Christian Kolberg, György Lövey, Leyla Akpolat-Basci, Miltiades Stephanou, Peter Fasching, Michael Untch, Oliver Hoffmann, Max Bulsara, Jayant Vaidya, Cornelia Liedtke
Introduction: In a previous study our group showed a beneficial effect of targeted intraoperative radiotherapy (TARGIT-IORT) as an intraoperative boost on overall survival after neoadjuvant chemotherapy (NACT) compared to an external boost (EBRT). In this study we present the results of a detailed subgroup analysis of the hormone receptor (HR)-positive HER2-negative patients. Methods: In this cohort study involving 46 patients with HR-positive HER2-negative breast cancer after NACT, we compared the outcomes of 21 patients who received an IORT boost to those of 25 patients treated with an EBRT boost...
October 2017: Breast Care
Chris Monten, Yolande Lievens
INTRODUCTION: A series of health economic evaluations (HEE) has analysed the efficiency of new fractionation schedules and techniques for adjuvant breast radiotherapy. This overview assembles the available evidence and evaluates to what extent HEE-results can be compared. METHODS: Based on a systematic literature review of HEEs from 1/1/2000 to 30/10/2016, all cost comparison (CC) and cost-effectiveness analyses (CEA) comparing different adjuvant breast radiotherapy approaches were analysed...
January 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Joanne S Haviland, Mariella Mannino, Clare Griffin, Nuria Porta, Mark Sydenham, Judith M Bliss, John R Yarnold
BACKGROUND AND PURPOSE: Adjuvant lymphatic radiotherapy (LNRT) is recommended for selected axillary node positive women with early breast cancer. We investigated whether hypofractionated LNRT is safe combined with similarly-hypofractionated breast/chest wall radiotherapy (RT). MATERIAL AND METHODS: The Standardisation of Breast Radiotherapy (START) pilot, A and B trials randomised women with early breast cancer to schedules of 2.67-3.3 Gy versus 2.0 Gy fractions (control)...
November 15, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Deva Petrova, Snezana Smickovska, Emilija Lazarevska
BACKGROUND: The treatment of breast cancer involves a multidisciplinary approach in which radiotherapy plays a key role. AIM: The conformity index and the homogeneity index are two analysis tools of a treatment plan using conformal radiotherapy. The purpose of this article is an analysis of these two parameters in the assessment of the treatment plans in 58 patients undergoing postoperative radiotherapy of the whole breast. MATERIALS AND METHODS: All 58 patients participating in the study had a conservatively treated early-stage breast cancer...
October 15, 2017: Open Access Macedonian Journal of Medical Sciences
Hung-Wen Lai, Liang-Chih Liu, Fu Ouyang, Chung-Chin Yao, Hsiang-Chun Jan, Ya-Herng Chang, Chi-Wen Tu, Dar-Ren Chen, Tsui-Fen Cheng, Yen-Dun Tzeng, Huan-Ming Hsu, Ming-Hsin Yeh, Yao-Chung Wu, Po-Sheng Yang, Hung-Bun Lam, Ming-Feng Hou, Fang-Ming Chen
BACKGROUND: In this multi-center study, we report the patient selection criteria for and preliminary oncologic outcomes associated with intraoperative radiotherapy (IORT) delivered by the Xoft Axxent® eBx® system for early-stage breast cancer in Taiwan. METHODS: Patients with early breast cancer in Taiwan received breast conserving surgery and received IORT with Xoft Axxent® eBx® System during 2013-2015 was search from database of Taiwan IORT study cooperative group (T-IORTSCG)...
2017: PloS One
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