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Vmat nodes "breast cancer"

Maija Rossi, Eeva Boman, Mika Kapanen
The objective of this study was to modify volumetric modulated arc therapy (VMAT) design for breast irradiation with axillary lymph node involvement to enhance normal tissue sparing while maintaining good planning target volume (PTV) coverage. Four VMAT plans were generated retrospectively for 10 patients with breast cancer for comparison. First, 2 partial arcs with an avoidance sector (Pavoid) for the lung and the heart were created. Second, a split-arc design with 2 partial arcs was used, changing the collimator angle by splitting the arcs in the middle, resulting in 4 partial arcs (Psplit)...
April 19, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
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...
June 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
Giuseppe Carlo Iorio, Pierfrancesco Franco, Elena Gallio, Stefania Martini, Francesca Arcadipane, Sara Bartoncini, Nadia Rondi, Francesca Romana Giglioli, Ada Ala, Mario Airoldi, Michela Donadio, Corrado De Sanctis, Isabella Castellano, Umberto Ricardi
To evaluate feasibility, safety, toxicity profile and dosimetric results of volumetric modulated arc therapy (VMAT) to deliver regional nodal irradiation (RNI) after either mastectomy or breast conservation (BCS) in high-risk breast cancer patients. Between January 2015 and January 2017, a total of 45 patients were treated with VMAT to deliver RNI together with whole breast or post-mastectomy radiotherapy. The fractionation schedule comprised 50 Gy in 25 fractions given to supraclavicular and axillary apex nodes and to whole breast (after BCS) or chest wall (after mastectomy)...
November 24, 2017: Medical Oncology
Juanqi Wang, Zhaozhi Yang, Weigang Hu, Zhi Chen, Xiaoli Yu, Xiaomao Guo
The purpose of this study is to evaluate the intensity modulated radiotherapy (IMRT) with the fixed collimator jaws technique (FJT) for the left breast and regional lymph node. The targeted breast tissue and the lymph nodes, and the normal tissues were contoured for 16 left-sided breast cancer patients previously treated with radiotherapy after lumpectomy. For each patient, treatment plans using different planning techniques, i.e., volumetric modulated arc therapy (VMAT), tangential IMRT (tangential-IMRT), and IMRT with FJT (FJT-IMRT) were developed for dosimetric comparisons...
May 16, 2017: Oncotarget
Alba Fiorentino, Rosario Mazzola, Stefania Naccarato, Niccolò Giaj-Levra, Sergio Fersino, Gianluisa Sicignano, Umberto Tebano, Francesco Ricchetti, Ruggero Ruggieri, Filippo Alongi
OBJECTIVES: The aim of the present retrospective analysis was to evaluate dosimetric parameters, feasibility and outcome for Synchronous Bilateral Breast Cancer (SBBC) patients treated with adjuvant radiotherapy (RT) by Volumetric Modulated Arc Therapy (VMAT). METHODS: From September 2011 to April 2016, 1100 Breast Cancer (BC) patients were referred to our institution to receive adjuvant breast RT, and those with SBBC were selected for the present analysis. A total of 16 patients were identified...
June 2017: La Radiologia Medica
Kathrin Surmann, Jorien van der Leer, Tammy Branje, Maurice van der Sangen, Maarten van Lieshout, Coen W Hurkmans
BACKGROUND: The aim of this study was to assess the dose to the humeral head planning risk volume with the currently used high tangential fields (HTF) and compare different planning techniques for breast radiotherapy including axillary level I and II lymph nodes (PTVn) while sparing the humeral head. METHODS: Ten patients with left-sided breast cancer were enrolled in a planning study with 16 fractions of 2.66 Gy. Four planning techniques were compared: HTF, HTF with sparing of the humeral head, 6-field IMRT with sparing of the humeral head and VMAT with sparing of the humeral head...
January 18, 2017: Radiation Oncology
T C F van Heijst, N Hoekstra, M E P Philippens, D Eschbach, J J W Lagendijk, H J G D van den Bongard, B van Asselen
PURPOSE: The Utrecht MRI-linac (MRL) design enables new MR-guided radiotherapy (RT) approaches. This is a feasibility study for a single-fraction high dose (boost) to individual lymph nodes (LNs) in breast-cancer patients, after breast-conserving surgery (BCS) and hypofractionated whole-breast irradiation (WBI) with conventional axillary RT (AxRT). METHODS: After written informed consent, 5 breast-cancer patients (cT1-3N0) were enrolled (NL500460.041.14 trial) and underwent 1...
June 2016: Medical Physics
Eeva Boman, Maija Rossi, Mikko Haltamo, Tanja Skyttä, Mika Kapanen
PURPOSE: To investigate different volumetric modulated arc therapy (VMAT) field designs for lymph node positive breast cancer patients when compared to conventional static fields and standard VMAT designs. METHODS: Nineteen breast cancer patients with lymph node involvement (eleven left and eight right sided) were retrospectively analyzed with different arc designs. Proposed split arc designs with total rotations of 2×190° and 2×240° were compared to conventional field in field (FinF) and previously published non-split arc techniques with the same amount of total rotations...
October 28, 2016: Physica Medica: PM
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...
November 11, 2016: Tumori
Olivier Lauche, Youlia M Kirova, Pascal Fenoglietto, Emilie Costa, Claire Lemanski, Celine Bourgier, Olivier Riou, David Tiberi, Francois Campana, Alain Fourquet, David Azria
AIM: To analyse clinical and dosimetric results of helical tomotherapy (HT) and volumetric modulated arc therapy (VMAT) in complex adjuvant breast and nodes irradiation. METHODS: Seventy-three patients were included (31 HT and 42 VMAT). Dose were 63.8 Gy (HT) and 63.2 Gy (VMAT) in the tumour bed, 52.2 Gy in the breast, 50.4 Gy in supraclavicular nodes (SCN) and internal mammary chain (IMC) with HT and 52.2 Gy and 49.3 Gy in IMC and SCN with VMAT in 29 fractions...
August 28, 2016: World Journal of Radiology
Yi-Jun Kim, Kyubo Kim, Rena Lee, Jiyoung Kim, Wonguen Jung, Nam-Sun Paik, Byung-In Moon, Woosung Lim, Jihae Lee
BACKGROUND/AIM: We evaluated dosimetric and clinical results of volumetric-modulated arc therapy (VMAT) treating internal mammary nodes (IMNs) in patients with locally advanced breast cancer. PATIENTS AND METHODS: Between July 2012 and December 2013, treatment outcomes of 31 patients with stage III breast cancer treated with postoperative radiotherapy including the IMN field using VMAT were analyzed. RESULTS: The median follow-up was 25.2 months...
2016: Anticancer Research
Maria Carmen De Santis, Francesca Bonfantini, Michela Dispinzieri, Silvia Meroni, Barbara Diletto, Elisa D Mantero, Marzia Franceschini, Fulvia Soncini, Serena Di Cosimo, Vito Cosentino, Emanuele Pignoli, Laura Lozza
PURPOSE: To evaluate the dosimetric coverage of axillary levels I, II, and III obtained with standard whole breast irradiation in 1 to 2 positive sentinel lymph nodes (SLNs) patients not submitted to axillary lymph nodes dissection (ALND), and to compare the lymph nodes areas coverage obtained with 3D conformal radiation therapy, intensity-modulated radiotherapy (IMRT), and volumetric modulated arc therapy (VMAT). METHODS: Patients with 1 to 2 positive SLNs undergoing breast-conserving therapy, without ALND, were included in the analysis...
August 3, 2016: Tumori
Jan Seppälä, Janne Heikkilä, Kimmo Myllyoja, Kristiina Koskela
PURPOSE: The treatment planning of bilateral breast irradiation (BBI) is a challenging task. The overlapping of tangential fields is usually unavoidable without compromising the target coverage. The purpose of this study was to investigate the technical feasibility and benefits of a single isocentre volumetric modulated arc therapy (VMAT) in BBI. METHODS AND MATERIALS: Two women with bilateral breast cancer were included in this case study. The first patient (Pat#1) underwent a bilateral breast-conserving surgery and sentinel lymph node biopsy...
September 2015: Reports of Practical Oncology and Radiotherapy
Marguerite Tyran, Hugues Mailleux, Agnes Tallet, Pierre Fau, Laurence Gonzague, Mathieu Minsat, Laurence Moureau-Zabotto, Michel Resbeut
We compared two intensity-modulated radiotherapy techniques for left-sided breast treatment, involving lymph node irradiation including the internal mammary chain. Inverse planned arc-therapy (VMAT) was compared with a forward-planned multi-segment technique with a mono-isocenter (MONOISO). Ten files were planned per technique, delivering a 50-Gy dose to the breast and 46.95 Gy to nodes, within 25 fractions. Comparative endpoints were planning target volume (PTV) coverage, dose to surrounding structures, and treatment delivery time...
November 2015: Journal of Radiation Research
Andrea Riccardo Filippi, Riccardo Ragona, Cristina Piva, Davide Scafa, Christian Fiandra, Marco Fusella, Francesca Romana Giglioli, Frank Lohr, Umberto Ricardi
PURPOSE: The purpose of this study was to evaluate the risks of second cancers and cardiovascular diseases associated with an optimized volumetric modulated arc therapy (VMAT) planning solution in a selected cohort of stage I/II Hodgkin lymphoma (HL) patients treated with either involved-node or involved-site radiation therapy in comparison with 3-dimensional conformal radiation therapy (3D-CRT). METHODS AND MATERIALS: Thirty-eight patients (13 males and 25 females) were included...
May 1, 2015: International Journal of Radiation Oncology, Biology, Physics
Qian Zhang, Xiao Li Yu, Wei Gang Hu, Jia Yi Chen, Jia Zhou Wang, Jin Song Ye, Xiao Mao Guo
BACKGROUND: The aim of the study was to evaluate the dosimetric benefit of applying volumetric modulated arc therapy (VMAT) on the post-mastectomy left-sided breast cancer patients, with the involvement of internal mammary nodes (IMN). PATIENTS AND METHODS: The prescription dose was 50 Gy delivered in 25 fractions, and the clinical target volume included the left chest wall (CW) and IMN. VMAT plans were created and compared with intensity-modulated radiotherapy (IMRT) plans on Pinnacle treatment planning system...
March 2015: Radiology and Oncology
Sonya Sergieva, Iglika Mihaylova, Elena Alexandrova, Milena Dimcheva, Luigi Mansi
The aim of modern intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) is to define the target areas including the smallest non-invaded margins, thus reducing the radiation dose to radiosensitive organs. To reach this goal, these methods require a more precise target delineation by imaging to better define the viable part of the tumor. Image-guided selection and demarcation of Gross Tumor Volume (GTV), Clinical Target Volume (CTV) and Organs at Risk (OAR) are the main steps to reach a satisfactory radiation treatment plan...
2015: Current Radiopharmaceuticals
Shanmugam Thirumalai Swamy, Chandrasekaran Anu Radha, Murugesan Kathirvel, Gandhi Arun, Shanmuga Subramanian
BACKGROUND: The purpose of this study was to assess the feasibility of deep inspiration breath-hold (DIBH) based volumetric modulated arc therapy (VMAT) for locally advanced left sided breast cancer patients undergoing radical mastectomy. DIBH immobilizes the tumor bed providing dosimetric benefits over free breathing (FB). MATERIALS AND METHODS: Ten left sided post mastectomy patients were immobilized in a supine position with both the arms lifted above the head on a hemi-body vaclock...
2014: Asian Pacific Journal of Cancer Prevention: APJCP
X Sharon Qi, Tian X Liu, Arthur K Liu, Francis Newman, Rachel Rabinovitch, Brian Kavanagh, Y Angie Hu
The 3-dimensional conformal radiotherapy (3DCRT) technique is the standard for breast cancer radiotherapy. During treatment planning, not only the coverage of the planning target volume (PTV) but also the minimization of the dose to critical structures, such as the lung, heart, and contralateral breast tissue, need to be considered. Because of the complexity and variations of patient anatomy, more advanced radiotherapy techniques are sometimes desired to better meet the planning goals. In this study, we evaluated external-beam radiation treatment techniques for left breast cancer using various delivery platforms: fixed-field including TomoDirect (TD), static intensity-modulated radiotherapy (sIMRT), and rotational radiotherapy including Elekta volumetric-modulated arc therapy (VMAT) and tomotherapy helical (TH)...
2014: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Sarah O S Osman, Sandra Hol, Philip M Poortmans, Marion Essers
PURPOSE: To investigate the effects of using volumetric modulated arc therapy (VMAT) and/or voluntary moderate deep inspiration breath-hold (vmDIBH) in the radiation therapy (RT) of left-sided breast cancer including the regional lymph nodes. MATERIALS AND METHODS: For 13 patients, four treatment combinations were compared; 3D-conformal RT (i.e., forward IMRT) in free-breathing 3D-CRT(FB), 3D-CRT(vmDIBH), 2 partial arcs VMAT(FB), and VMAT(vmDIBH). Prescribed dose was 42...
July 2014: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
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