A heart atlas for breast radiation therapy and the influence of delination education on both intra and interobserver variability

AbstractPurposeWe developed a heart atlas for breast radiation therapy and evaluated the influence of education on intra and inter-observer similarity, and cardiac dose reporting.Materials and methodsThe data of 16 left breast cancer patients were analyzed. Eight observers delineated heart and cardiac subunits [left (LCA) and right (RCA) coronary arteries, left anterior descending artery (LAD), bilateral atrium and ventricles] before the education. A radiologist and radiation oncologist developed the atlas and delineated the gold standard (GS) volumes. Observers repeated the delineation after education. RT plans were made for pre/post-atlas contours. The similarity was assessed by Dice (DSC) and Jaccard (JSC) similarity coefficient indices. The absolute difference rate was calculated for the dose analysis.ResultsThe inter-observer similarity increased in heart and all subunits. The intra-observer similarity showed a heterogeneous distribution. The absolute difference rate in dose reporting was statistically significant for the bilateral atrium, right ventricle, LAD, LCA  + LAD, RCA’s maximum doses (p 
Source: Japanese Journal of Radiology - Category: Radiology Source Type: research

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Publication date: Available online 22 June 2019Source: Practical Radiation OncologyAuthor(s): Bindu V. Manyam, Chirag Shah, Neil M. Woody, Chandana A. Reddy, Michael A. Weller, Aditya Juloori, Mihir Naik, Stephanie Valente, Stephen Grobmyer, Paul Durand, Risal Djohan, Rahul D. TendulkarAbstractPurposeThe toxicity profile of breast reconstruction with post-mastectomy radiation therapy (PMRT) varies by technique and timing, and long-term data are limited. We compared rates of complications requiring re-operation (CRR) and reconstruction failure (RF) between immediate autologous reconstruction (I-AR), immediate tissue expande...
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
This study is another example of many efforts underway to achieve this goal. The authors have appropriately targeted an older population of breast cancer patients for which there have been randomized clinical data confirming equivalent outcomes for patients treated with and without radiation therapy, and nonrandomized data showing equivalent outcomes for patients older than 70 years with axillary dissection or observation.
Source: Journal of the American College of Surgeons - Category: Surgery Tags: Western surgical association article Source Type: research
ConclusionsIORT is a safe and effective alternative to whole breast radiotherapy, and serves as a suitable alternative to completion mastectomy in locally recurrent breast cancer.Summary for the table of contentsA multidisciplinary breast cancer center experience of intraoperative radiation therapy (IORT) in early stage breast cancer patients. Single high dose IORT was implemented in lieu of prolonged daily whole breast radiation as part of breast conserving therapy. IORT was found to be safe and effective alternative to WBRT in select early stage breast cancer patients.
Source: The American Journal of Surgery - Category: Surgery Source Type: research
AbstractPurposeTo report the dosimetric feasibility of the radiation technique HALFMOON (Helical ALtered Fractionation for iMplant partial OmissiON) for post-mastectomy radiation therapy (PMRT) in intermediate –high-risk breast cancer patients with implant-based immediate breast reconstruction, where the clinical target volume (CTV) does not include the whole implant (implant-sparing approach).MethodsIn the HALFMOON technique, the CTV consisted of skin, subcutaneous tissues, and pectoralis major muscle, excluding the implant, chest wall muscles, and rib plane. The HALFMOON plans were compared with conventionally cont...
Source: Journal of Cancer Research and Clinical Oncology - Category: Cancer & Oncology Source Type: research
We investigated the effectiveness and economic implications of radiation therapy alone (without endocrine therapy) for women with low-risk early ER+ breast cancer who are age 70 or over. We created a Markov microsimulation based on available prospective data. The model demonstrated that both treatments were comparable, although radiation was more expensive in the long run by $3,809.
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Source Type: research
Abstract Supplementation with the antioxidant selenium is frequently performed in breast cancer patients to protect the normal tissue from radiation-induced side effects. However, concerns exist whether selenium also protects tumor cells from radiation-induced cell kill and thereby reduces the efficacy of radiotherapy. In this work, the effect of selenium administration on the radiosensitivity of breast cancer cells was evaluated in vitro. Physiological relevant selenium concentrations (70 and 140 µg/l) did not affect DNA double-strand breaks (γH2AX foci) after 4-Gy X-ray irradiation. Also apoptos...
Source: Radiation and Environmental Biophysics - Category: Physics Authors: Tags: Radiat Environ Biophys Source Type: research
ConclusionThe preferred treatment is always aggressive surgical removal and, as our atypical clinical case suggests, neoadjuvant chemotherapy in very high doses is also needed. A biopsy of any suspicious breast skin lesion after radiotherapy is recommended. Despite the treatment challenges, our case provides enlightening details on the management of such a rare cancer even when faced with unplanned events which do not always allow for a textbook approach.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
ConclusionsTo the best of our knowledge, this is the first dedicated prospective trial evaluating long-term cosmetic and complication outcomes in patients treated with immediate TE-ADM reconstruction followed by PMRT. Most patients (65.4%) met the success criteria in this prospective single-arm series. The great majority (93.5%) achieved final reconstruction; most had good-to-excellent overall cosmetic outcomes (79.2%). The results with longer follow-up will be of interest, and further investigation of strategies to optimize reconstruction with PMRT are warranted.
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
We report a case of radiation recall syndrome in a breast cancer patient, after introduction of everolimus. A woman with a right breast cancer underwent a mastectomy, then adjuvant chemotherapy, radiation therapy and hormonotherapy. In a phase III trial (UNIRAD protocol), she received everolimus 5 months after radiation therapy. Seven days after introduction, she was suffering from a radiation recall syndrome with exacerbation skin reactions. The exact pathophysiological mechanism of radiation recall syndrome is unknown. The combination of radiation therapy and mTor inhibitor, even sequentially, should be done with caution...
Source: Cancer Radiotherapie - Category: Cancer & Oncology Authors: Tags: Cancer Radiother Source Type: research
Authors: Kolberg HC, Schneeweiss A, Fehm TN, Wöckel A, Huober J, Pontones C, Titzmann A, Belleville E, Lux MP, Janni W, Hartkopf AD, Taran FA, Wallwiener M, Overkamp F, Tesch H, Ettl J, Lüftner D, Müller V, Schütz F, Fasching PA, Brucker SY Abstract The treatment of breast cancer patients in a curative situation is special in many ways. The local therapy with surgery and radiation therapy is a central aspect of the treatment. The complete elimination of tumour cells at the site of the primary disease must be ensured while simultaneously striving to keep the long-term effects as minor as possible...
Source: Geburtshilfe und Frauenheilkunde - Category: OBGYN Tags: Geburtshilfe Frauenheilkd Source Type: research
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