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Dose constraints in breast cancer radiotherapy. A critical review.
Radiother Oncol
January 2025
Department of Radiation Oncology, University Hospital of Modena, Modena, Italy.
Radiotherapy plays an essential role in the treatment of breast cancer (BC). Recent advances in treatment technology and radiobiological knowledge have a major impact in BC patients with locoregional disease as the majority are now long-term survivors. Over the last three decades, intensity-modulated radiotherapy (IMRT), volumetric-modulated arc therapy (VMAT) and deep inspiration breath-hold (DIBH) techniques, together with the increasing adoption of moderately hypofractionated and ultra-hypofractionated treatment schedules as well as the possibility to offer partial breast radiotherapy to a well-defined patient subset have significantly changed radiotherapy for BC patients.
View Article and Find Full Text PDFDose Deintensified 3-Day Photon, Proton, or Brachytherapy: A Nonrandomized Controlled Partial Breast Irradiation Trial.
Int J Radiat Oncol Biol Phys
September 2024
Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota.
Purpose: The optimal approach for partial breast irradiation (PBI) is unknown. We investigated a novel de-intensified 3-fraction PBI regimen for photons, protons, and brachytherapy.
Methods And Materials: A multicenter nonrandomized controlled trial with the primary outcome of adverse cosmesis at 3 years versus before PBI.
Locoregional Recurrence in Adenoid Cystic Carcinoma of the Breast: A Retrospective, Multicenter Study (KROG 22-14).
Cancer Res Treat
July 2024
Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Article Synopsis
- The study investigates treatment methods and local recurrence patterns for Adenoid cystic carcinoma (ACC) in the breast, a rare type of cancer with limited existing research.
- Researchers analyzed data from 93 patients diagnosed with primary ACC between 1992 and 2022, finding that 80.7% underwent breast-conserving surgery (BCS), with a significant number receiving post-operative radiation therapy (PORT).
- Results showed an 84.2% locoregional recurrence-free survival rate at 5 years, with most local recurrences occurring in the tumor bed, suggesting that BCS followed by PORT is an effective approach for treating primary breast ACC.
Differences in Patterns of Care and Referral Between Proton and Photon Therapy.
Int J Part Ther
March 2024
New York Proton Center, New York, NY, USA.
Purpose: To report demographic and clinical characteristics of patients who were more likely to receive proton beam therapy (PBT) than photon therapy from facilities with access to proton centers.
Materials And Methods: We utilized the national cancer database to identify the facilities with access to PBT between 2004 and 2015 and compared the relative usage of photons and PBT for demographic and clinical scenarios in breast, prostate, and nonsmall cell cancer.
Results: In total, 231 facilities with access to proton centers accounted for 168 323 breast, 39 975 lung, and 77 297 prostate cancer patients treated definitively.
In early breast cancer, adjuvant moderately hypofractionated regimens are recommended for both whole breast, partial breast and locoregional irradiation which abbreviates the overall treatment time, as argued in this review. Gating is recommended as well as the use of a simultaneous integrated boost when indicated. A tangential field set-up is standard, however, for challenging cases volumetric modulated arc therapy techniques, or referral for proton therapy, may be considered.
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