To determine whether small field boost (SFB) replanning is necessary when the lumpectomy cavity (LPC) decreases during whole-breast irradiation (WBI) and what parameters might predict a change in the SFB plan. Forty patients had computed tomography (CT) simulation (CT1) within 60 days of surgery and were resimulated (CT2) after 37.8-41.4 Gy for SFB planning. A 3-field photon plan and a single en face electron plan were created on both CTs and compared. In the 26 patients who had a ≥5 cm(3) and a ≥25% decrease in lumpectomy cavity volume (LCV) between CT scans, the SFB plan using photons was different in terms of normal breast tissue volume irradiated (BTV) (p < 0.001), and field dimensions (p < 0.001). In 20/35 patients, the energy or field size changed for electron plans on CT2, but no tested characteristics predicted for a change. Less BTV was irradiated using electrons than photons in 29% (CT1) to 37% (CT2). SFB replanning needs to be individualized to each patient because of the variety of factors that can impact dosimetric planning. Replanning is recommended when using 3-field photons if the patient has experienced a ≥5 cm(3) and a ≥25% decrease in LCV during WBI. Some patients may benefit from electron SFB replanning but no tested characteristics reliably predict those who may benefit the most. The amount of BTV irradiated is less with electrons than in photon plans and this has the potential to improve cosmesis, a clinically important outcome in breast-conserving therapy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.meddos.2011.11.008 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
"When Less is More": Paradigm Shifts in Radiation Treatment for Early-Stage Breast Cancer.
Curr Treat Options Oncol
December 2024
Department of Breast Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
Article Synopsis
- Recent advancements in breast cancer treatment have altered traditional radiotherapy practices, moving from lengthy regimens to potentially only 5 treatments in a week for selected patients.
- Ultra-hypofractionated regimens and partial breast irradiation have shown efficacy and tolerability, offering alternatives to whole breast radiation.
- The evolving research emphasizes patient-centered care, highlighting the importance of personalized treatment plans and shared decision-making in oncology.
Clinical validation on role of cancer diagnostic probe in detecting the involved cavity margins missed in permanent pathology of tumor side in breast cancer surgery.
Diagn Pathol
November 2024
Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Cancer diagnostic probe (CDP) as a newly entered tool in real-time breast cavity margin evaluation showed great improvement in smart margin shaving intra-operatively. This system increased the rate of involved margin detection to 30% with respect to frozen section. In this study for the first time we showed the independent role of CDP in finding the involved cavity side margins which were not diagnosed by permananet pathology of their tumor side interface.
View Article and Find Full Text PDFComparative study of lidocaine- saline versus saline as washout for lumpectomy cavity on acute postoperative pain.
Heliyon
October 2024
Department of Surgery, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Purpose: This study aimed to evaluate the impact of lidocaine-saline solution compared to saline alone for washing out the lumpectomy cavity, focusing on its effect on acute postoperative pain-a prevalent and significant concern among patients undergoing breast surgery.
Methods: In this comparative study, 72 patients scheduled for lumpectomy surgery were randomly assigned to either the lidocaine-saline or saline group. The lidocaine-saline group was administered a washout of the lumpectomy cavity with 2 % lidocaine at a dosage of 1.
Interobserver variability of clinical target volume delineation in patients undergoing breast-conserving surgery without surgical clips: a pilot study on preoperative magnetic resonance simulation.
BMC Cancer
October 2024
Department of Radiation Oncology, Peking Union Medical College Hospital Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, People's Republic of China.
Background: In patients undergoing breast-conserving therapy without surgical clip implantation, the accuracy of tumor bed identification and the consistency of clinical target volume (CTV) delineation under computed tomography (CT) simulation remain suboptimal. This study aimed to investigate the feasibility of implementing preoperative magnetic resonance (MR) simulation on delineations by assessing interobserver variability (IOV).
Methods: Preoperative MR and postoperative CT simulations were performed in patients who underwent breast-conserving surgery with no surgical clips implanted.
Comparative long-term oncological outcomes of intraoperative radiotherapy vs. whole-breast irradiation in early breast cancer: a single institute study.
Front Oncol
October 2024
Department of General Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Background: Intraoperative radiation therapy (IORT) and whole breast irradiation (WBI) are both effective adjuvant radiotherapy methods for ductal carcinoma (DCIS) or early-stage breast cancer (BC) patients undergoing breast-conserving surgery (BCS). We aim to evaluate the long-term oncological efficacy and refine patient selection criteria based on our findings.
Methods: Female patients who underwent either IORT or WBI from January 2016 to December 2019, with a minimum follow-up of 12 months were collected.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!