Recent Time Trends and Predictors of Heart Dose From Breast Radiation Therapy in a Large Quality Consortium of Radiation Oncology Practices.

Recent Time Trends and Predictors of Heart Dose From Breast Radiation Therapy in a Large Quality Consortium of Radiation Oncology Practices. Int J Radiat Oncol Biol Phys. 2017 Dec 01;99(5):1154-1161 Authors: Pierce LJ, Feng M, Griffith KA, Jagsi R, Boike T, Dryden D, Gustafson GS, Benedetti L, Matuszak MM, Nurushev TS, Haywood J, Radawski JD, Speers C, Walker EM, Hayman JA, Moran JM, Michigan Radiation Oncology Quality Consortium Abstract PURPOSE: Limited data exist regarding the range of heart doses received in routine practice with radiation therapy (RT) for breast cancer in the United States today and the potential effect of the continual assessment of the cardiac dose on practice patterns. METHODS AND MATERIALS: From 2012 to 2015, 4688 patients with breast cancer treated with whole breast RT at 20 sites participating in a state-wide consortium were enrolled into a registry. The importance of limiting the cardiac dose has been emphasized in the consortium since 2012, and the mean heart dose (MHD) has been reported by each institution since 2014. The effects on the MHD were estimated for both conventional and accelerated fractionation using regression models, with technique (intensity modulated RT [IMRT] vs 3-dimensional conformal RT), deep inspiration breath hold use, patient position (supine vs prone), nodal RT (if delivered), and boost (yes vs no) as covariates. RESULTS: For left-sided breast cancer treated with conventional fractionation,...
Source: Physics in Medicine and Biology - Category: Physics Authors: Tags: Int J Radiat Oncol Biol Phys Source Type: research

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era S Abstract Adjuvant radiotherapy is a key treatment in early-stage breast cancer. The meta-analysis by the Early Breast Cancer Trialist's Collaborative Group (EBCTCG) has demonstrated a decreased risk of locoregional relapse and death after whole-breast radiotherapy. Prophylactic lymph nodes irradiation in breast cancer has also proven to be beneficial in several therapeutic trials. At a time when three-dimensional conformal radiotherapy has become the standard procedure and with the development of intensity-modulated radiation therapy, defining nodal volumes is essential and practices should be harmonized to ...
Source: Cancer Radiotherapie - Category: Cancer & Oncology Authors: Tags: Cancer Radiother Source Type: research
Abstract Randomized trials demonstrated similar overall survival between mastectomy and breast-conservative surgery followed by adjuvant radiation therapy. Breast-conservative surgery, with adjuvant radiation therapy, with or without neoadjuvant systemic therapy has become the standard of care for women with early or locally advanced breast cancer. Nevertheless, certain cardiac, lung or cutaneous toxicities may alter the long-term body image and the quality of life of a limited number of patients who consider having had "overtreatment" or treatment outside the best knowledge of science. In case of low-ri...
Source: Cancer Radiotherapie - Category: Cancer & Oncology Authors: Tags: Cancer Radiother Source Type: research
ConclusionBased on the available findings, the DEGRO breast cancer expert panel recommends the use of DIBH as the best heart-sparing technique. Nonetheless, depending on the treatment volume and localization, other techniques may be employed or combined with DIBH when appropriate.
Source: Strahlentherapie und Onkologie - Category: Cancer & Oncology Source Type: research
CONCLUSION: The overall estimation of EAR indicated that the radiation-induced cancer risk of breast radiation therapy was lower with FinF than with IMRT and VMAT. Therefore, when secondary cancer risk is a major concern, FinF is considered to be the preferred treatment option in irradiation of whole-breast. ADVANCES IN KNOWLEDGE: Secondary malignancy estimation after breast radiotherapy is becoming an important subject for comparative treatment planning.When secondary cancer risk a major concern, FinF technique is considered the preferred treatment option in whole breast patients. PMID: 31295011 [PubMed - as supplied by publisher]
Source: The British Journal of Radiology - Category: Radiology Authors: Tags: Br J Radiol Source Type: research
Abstract OBJECTIVE: To evaluate dose to organs at risk, target coverage and treatment compliance in left sided breast cancer patients (LSBCP) treated with deep inspiration breath hold (DIBH) and intensity modulated radiation therapy (IMRT) technique in a contest of daily clinical practice. METHODS: A total of 280 consecutive LSBCP referred for adjuvant radiotherapy were systematically screened for suitability of DIBH technique. Two hundred thirty-nine were able to comply with the requirement for DIBH. Whole breast or chest wall were irradiated in DIBH, monitored by Varian RPM™ Respiratory Gating System,...
Source: The British Journal of Radiology - Category: Radiology Authors: Tags: Br J Radiol Source Type: research
AbstractAutomated treatment planning may decrease the effort required in planning and promote increased routine clinical use of intensity-modulated radiation therapy (IMRT) for many breast cancer patients. The aim of this study was to evaluate a new commercial automated planning software for tangential breast IMRT by comparing it with clinical plans from whole-breast irradiation. We prospectively enrolled 150 patients with Stage 0 –1 breast cancer who underwent breast-conserving surgery at our institution between September 2016 and August 2017. Total doses of 42.56 Gy in 16 fractions (n  =  98) or ...
Source: Radiological Physics and Technology - Category: Physics Source Type: research
ConclusionsAPBI using 27 Gy in 5 daily fractions achieved acceptable 1-year cosmesis and no grade 2 fibrosis. A preplanned stopping rule of 5% grade 2+ fibrosis was not observed. The trial will continue to the planned target accrual of 274 patients.
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
Conclusion: The Halcyon™ dual-layer MLC can generate comparable and clinically equivalent spine SBRT plans to TrueBeam plans with less rapid dose fall-off and lower conformity. MLC width leaf can impact maximum dose to organs at risk and plan quality, but does not cause limitations in achieving acceptable plans for spine SBRT treatments. Introduction Stereotactic body radiotherapy treatment (SBRT) for metastatic spinal tumors necessitates radiation treatment plans with high dose targets immediately adjacent to the spinal cord. To achieve uniform coverage while maintaining safe doses to the spinal cord, steep ...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Conclusions: 3D-HDR-BT achieves favorable clinical outcomes with mild late toxicity in patients with locally rNPC. Introduction Nasopharyngeal carcinoma (NPC), a tumor of epithelial origin, is a malignant disease of the head and neck common in southern China, especially in Guangdong province (1). As a result of advances in modern imaging and irradiation techniques, the 5-year overall survival (OS) of patients with newly diagnosed NPC without metastasis has reached 75% after external beam radiotherapy (EBRT) in Asia (2, 3). However, local recurrence, which occurs in 18–40% of patients, remains a major reason for...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Viacheslav Soyfer1* and Benjamin W. Corn2 1Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel 2Shaare Zedek Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel Outcomes for patients with locally-advanced Non Small Cell Lung Cancer (NSCLC) remain poor. In the context of definitive (as opposed to neoadjuvant) treatment, radiation oncologists have traditionally embraced dose escalation as a means to improve control of the primary tumor as well as draining nodal regions for this clinical problem. Yet we wonder: is it optimal—or even rational—to treat the primary and the medi...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
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