Time-driven activity-based costing of a novel form of CT-guided high-dose-rate brachytherapy intraoperative radiation therapy compared with conventional breast intraoperative radiation therapy for early stage breast cancer

Intraoperative radiation therapy is an emerging option for adjuvant therapy for early stage breast cancer, although it is not currently considered standard of care in the United States. We applied time-driven activity-based costing to compare two alternative methods of breast intraoperative radiation therapy, including treatment similar to the techniques employed in the TARGIT-A clinical trial and a novel version with CT-guidance and high-dose-rate (HRD) brachytherapy.
Source: Brachytherapy - Category: Cancer & Oncology Authors: Source Type: research

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Abstract Brachytherapy is an invasive therapy with placement of radiation source into or near the tumor. The difference between planning target volume and clinical target volume is minimal, and the dose out of the tumor reduces rapidly due to the inverse-square law. High-dose-rate brachytherapy enables three-dimensional image guidance, and currently, tumor dose as well as doses of the surrounding normal structures can be evaluated accurately. High-dose-rate brachytherapy is the utmost precision radiation therapy even surpassing carbon ion therapy. Biological disadvantages of high-dose rate have been overcome by th...
Source: Clinical Prostate Cancer - Category: Cancer & Oncology Authors: Tags: Jpn J Clin Oncol Source Type: research
Publication date: Available online 5 December 2019Source: The LancetAuthor(s): Frank A Vicini, Reena S Cecchini, Julia R White, Douglas W Arthur, Thomas B Julian, Rachel A Rabinovitch, Robert R Kuske, Patricia A Ganz, David S Parda, Michael F Scheier, Kathryn A Winter, Soonmyung Paik, Henry M Kuerer, Laura A Vallow, Lori J Pierce, Eleftherios P Mamounas, Beryl McCormick, Joseph P Costantino, Harry D Bear, Isabelle GermainSummaryBackgroundWhole-breast irradiation after breast-conserving surgery for patients with early-stage breast cancer decreases ipsilateral breast-tumour recurrence (IBTR), yielding comparable results to m...
Source: The Lancet - Category: General Medicine Source Type: research
To dosimetrically compare interstitial brachytherapy (MIBT) vs. EBRT (3DCRT and high-energy electron beams) for deep-seated tumor bed boosts (depth ≥4 cm) in early-stage breast cancer.
Source: Brachytherapy - Category: Cancer & Oncology Authors: Source Type: research
We report here oncological outcomes and toxicity of hypofractionated breast irradiation. After defining the frame of moderate and extreme hypofractionated breast irradiations based on overall treatment time, patient selection criteria were listed. According to their levels of proof, the results of moderate and extreme hypofractionated breast irradiation were analysed. Overall treatment time for moderate hypofractionated breast irradiation ranged from 3 to 4 weeks, while for extreme hypofractionated breast irradiation, it was less than 1 week. For moderate hypofractionated breast irradiation, whole breast irradiation w...
Source: Cancer Radiotherapie - Category: Cancer & Oncology Authors: Tags: Cancer Radiother Source Type: research
AbstractPurpose of ReviewFollowing partial mastectomy, whole-breast irradiation (WBI), delivered over 3 to 6  weeks, has been the standard adjuvant radiation approach for early-stage breast cancer. A growing body of literature over the past decade has suggested that irradiation of the partial breast, including the tumor bed plus a margin, may be a suitable alternative for appropriately selected patients. The use of partial breast irradiation (PBI) has been studied in multiple prospective randomized trials, now with up to 10 years of follow-up, establishing similar safety and efficacy compared with WBI. Advantages...
Source: Current Breast Cancer Reports - Category: Cancer & Oncology 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
ConclusionPRT/PCRT is associated with low grades of fibrosis and a  good to excellent long-term cosmetic outcome.
Source: Strahlentherapie und Onkologie - Category: Cancer & Oncology Source Type: research
This report details our experience using accelerated partial breast irradiation (APBI) as a component of salvage breast conserving treatment.
Source: Brachytherapy - Category: Cancer & Oncology Authors: Source Type: research
Randomized trials in selected early stage breast cancer patients with up to 10 year follow-up have proven that Accelerated Partial Breast Irradiation (APBI) given via High Dose Rate (HDR) implant bid in 5 days is equivalent to whole breast External Radiation Therapy (XRT) given qd in 5-6 weeks in regard to breast tumor local recurrence (LR) [1-2]. However, complications with APBI implant in a Medicare database review have been significant, with 3.95% of women requiring Mastectomy, 16.2% developing infections, and another 16.3% experiencing non-infection complications including rib fractures, fat necrosis, and breast pain [3].
Source: Brachytherapy - Category: Cancer & Oncology Authors: Source Type: research
To compare radiation lung dose in patients with early-stage breast cancer treated with lumpectomy and intraoperative radiation therapy with CT-guided HDR brachytherapy (Precision Breast IORT; PB-IORT) and those treated with whole breast irradiation (WBI-DIBH) or partial breast irradiation (PB-DIBH) with deep inspiratory breath hold.
Source: Brachytherapy - Category: Cancer & Oncology Authors: Source Type: research
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