27 The effect of high-dose-rate brachytherapy (HDR-bBT) and electron boost on local control and side effects after breast conserving surgery (BCS): First results of the randomized Budapest breast boost trial

Polgár, C.; Orosz, Zsolt; Fodor, János; Major, Tibor; Somogyi, A.; Kásler, Miklós; Németh, György

doi:10.1016/s0167-8140(01)80034-7

Cited by 8 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The principal objective of breast conservation therapy is to provide local control that is equivalent to that of mastectomy without compromising cosmetic outcomes . Cumulative evidence from multiple retrospective and prospective studies, and systematic analyses has substantiated the correlation between local control and the extent of margins given around the tumor bed during radiation . However, balancing this benefit against an increased possibility of breast fibrosis, necrosis, and poor cosmesis is paramount for achieving an optimal therapeutic index.…”

Section: Discussionmentioning

confidence: 99%

“…5 Cumulative evidence from multiple retrospective and prospective studies, and systematic analyses has substantiated the correlation between local control and the extent of margins given around the tumor bed during radiation. 6,[14][15][16] clips. 20 Multiple similar studies have established surgical clips as accurate surrogates for target delineation to improve therapeutic outcomes.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of four‐dimensional simulation of boost radiation after breast conservation surgery: A prospective dosimetric and volumetric analysis

Kapoor

Gupta

Miriyala

et al. 2018

Precision Radiation Oncology

View full text Add to dashboard Cite

Objective Breast conservation therapy is the standard of care for early breast cancer. After whole breast irradiation, lumpectomy cavity boost increases local control and survival. However, accurate identification of the tumor bed and internal displacement caused by respiratory movements poses major challenges in achieving the optimal therapeutic index. Although surgical clips are considered accurate surrogates for localization of the tumor bed, no consensus has been reached regarding the use of motion management during treatment delivery. The purpose of the present study was to evaluate the dosimetric and volumetric effects of respiratory motion on the delivery of boost radiation using 4‐D computed tomography simulation. Methods A total of 25 patients undergoing tumor bed boost radiation were recruited prospectively. Dosimetric and volumetric comparisons were made between conformal plans formed with 3‐D and 4‐D datasets obtained from each patient. Results No significant differences were observed in target volumes, degrees of inclusion, conformity indices, or homogeneity indices between the plans formed with the two datasets (P < 0.05). The magnitude of internal movement of the tumor bed was insignificant compared with the margin for setup errors. Conclusion Displacement of the tumor bed caused by respiratory motion was minimal with insignificant dosimetric or volumetric effects, and does not warrant the routine use of 4‐D simulation or the generation of internal target volumes.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effects of four‐dimensional simulation of boost radiation after breast conservation surgery: A prospective dosimetric and volumetric analysis

Kapoor

Gupta

Miriyala

et al. 2018

Precision Radiation Oncology

View full text Add to dashboard Cite

show abstract

“…In contradiction to the theoretical relevance of multifocality, results of large well controlled studies have proved that 67-100% of postlumpectomy breast recurrences occurred in the vicinity of the tumor bed [7,13,14,33,53]. The rate of elsewhere breast failures after breast conservation have been reported in the range of 0-3.8%, and was not affected by whole breast radiotherapy (Table 1) [7,12,14,26,41,42,45,54,56]. These results suggest that radiotherapy exerts its maximal effect on residual tumor foci in the tumor bearing quadrant.…”

Section: Pathological and Clinical Basis For Limiting Radiotherapy Tomentioning

confidence: 99%

Radiotherapy Confined to the Tumor Bed Following Breast Conserving Surgery

Polgár

Fodor

Major

et al. 2002

Strahlentherapie und Onkologie

View full text Add to dashboard Cite

In spite of the existing arguments against limiting radiotherapy to the tumor bed after breast conserving surgery, results of phase I-II studies suggest that tumor bed radiotherapy alone might be an appropriate treatment option for selected breast cancer patients. Whole breast radiotherapy remains the standard radiation modality used in the treatment of breast cancer, and brachytherapy as the sole modality should be considered as investigational. Further phase-III trials are suggested to determine the equivalence of sole tumor bed radiotherapy, compared with whole breast radiotherapy. Preliminary results with recently developed techniques (CT-image based conformal brachytherapy, 3-D virtual brachytherapy, IORT, 3-D-CRT) are promising. However, more experience is required to define whether these methods might improve outcome for patients treated with tumor bed radiotherapy alone.

show abstract

The role of boost irradiation in the conservative treatment of stage I-II breast cancer

Polgár

Fodor

Major

et al. 2001

Pathol. Oncol. Res.

View full text Add to dashboard Cite

In this article, we review the current status, indication, technical aspects, controversies, and future prospects of boost irradiation after breast conserving surgery (BCS). BCS and radiotherapy (RT) of the conserved breast became widely accepted in the last decades for the treatment of early invasive breast cancer. The standard technique of RT after breast conservation is to treat the whole breast up to a total dose of 45 to 50 Gy. However, there is no consensus among radiation oncologists about the necessity of boost dose to the tumor bed. Generally accepted criteria for identification of high risk subgroups, in which boost is recommended, have not been established yet. Further controversy exists regarding the optimal boost technique (electron vs. brachytherapy), and their impact on local tumor control and cosmesis. Based on the results of numerous retrospective and recently published prospective trials, the European brachytherapy society (GEC-ESTRO), as well as the American Brachytherapy Society has issued their guidelines in these topics. These guidelines will help clinicians in their medical decisions. Some aspects of boost irradiation still remain somewhat controversial. The final results of prospective boost trials with longer follow-up, involving analyses based on pathologically defined subgroups, will clarify these controversies. Preliminary results with recently developed boost techniques (intraoperative RT, CT-image based 3D conformal brachytherapy, and 3D virtual brachytherapy) are promising. However, more experience and longer follow-up are required to define whether these methods might improve local tumor control for breast cancer patients treated with conservative surgery and RT.

show abstract

27 The effect of high-dose-rate brachytherapy (HDR-bBT) and electron boost on local control and side effects after breast conserving surgery (BCS): First results of the randomized Budapest breast boost trial

Cited by 8 publications

References 0 publications

Effects of four‐dimensional simulation of boost radiation after breast conservation surgery: A prospective dosimetric and volumetric analysis

Effects of four‐dimensional simulation of boost radiation after breast conservation surgery: A prospective dosimetric and volumetric analysis

Radiotherapy Confined to the Tumor Bed Following Breast Conserving Surgery

The role of boost irradiation in the conservative treatment of stage I-II breast cancer

Contact Info

Product

Resources

About