5-year results of accelerated partial breast irradiation (APBI) with SBRT (stereotactic body radiation therapy) and exactrac adaptive gating (Novalis®) for very early breast cancer patients: was it all worth it?

Ciérvide, R.; Montero, Á.; Potdevin, G.; García, Juan Diego Mediavilla; Aranda, M. Garcia; Álvarez, B.; Rossi, Kyle C.; López, M.; Hernando, O.; Valero, J.; Sánchez, E.; Chen, Xuyu; Alonso, R.; Letón, P. Fernández; Rubio, Carmen

doi:10.1007/s12094-021-02636-3

Cited by 10 publications

(9 citation statements)

References 52 publications

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“…A final list of 15 articles ( 24 – 38 ) ( Tables 1 , 2 ) were included in full manuscript review. All studies included patients with early BC who were treated over 8 years from 2009 and 2021.…”

Section: Resultsmentioning

confidence: 99%

“…A recent phase II trial ( 38 ) was published with the longest fup, assessing 23 early-BC patients for the feasibility of postoperative SPBI and the ExacTrac Adaptive Gating System: with a median fup of 66 months, LR-free survival reaches 100%. One patient developed a second BC outside the treated quadrant after 25.1 months.…”

Section: Resultsmentioning

confidence: 99%

“…Currently, the use of gold fiducials at the level of tumor bed and the evolution of radiation techniques, such as MR-guided RT ( 26 – 28 ), the real-time tracking and respiratory motion control of the CK system ( 46 ) or ExacTrac Adaptive Gating System (Novalis ® ) ( 38 , 47 , 48 ), and some new breast devices ( 49 – 51 ), have also heightened the interest in the use of SPBI in the adjuvant setting, reducing radiation delivery uncertainty related to the pliability and mobility of the breast tissue and a more accurate dose distribution, limiting the dose at OARs.…”

Section: Discussionmentioning

confidence: 99%

“…The main advantage is the reduction or the omission of CTV to PTV margins both in neoadjuvant and adjuvant PBI with a better visualization of the target volume during treatment. PTV intrafraction motion can be controlled through the irradiation delivered in a selected gated area of the respiratory cycle with respiratory gating systems ( 38 ). The modern CK radiosurgery system also delivers a relatively steep dose gradient outside and within the target, mimicking the accurate brachytherapy dose distribution, and it proved to limit normal breast tissue toxicity with good cosmesis ( 30 – 32 , 35 , 37 , 46 , 53 ).…”

Section: Discussionmentioning

confidence: 99%

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Stereotactic partial breast irradiation in primary breast cancer: A comprehensive review of the current status and future directions

Takanen

Pinnarò²,

Farina³

et al. 2022

Front. Oncol.

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In selected low-risk breast cancer patients, accelerated partial breast irradiation (APBI) may represent an alternative option to the whole breast irradiation to reduce the volume of irradiated breast and total treatment duration. In the last few years, preliminary data from clinical trials showed that stereotactic partial breast radiotherapy may have the advantage to be less invasive compared to other APBI techniques, with preliminary good results in terms of local toxicity and cosmesis: the use of magnetic resonance, fiducial markers in the tumor bed, and new breast devices support both a precise definition of the target and radiation planning.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021257856, identifier CRD42021257856.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Stereotactic partial breast irradiation in primary breast cancer: A comprehensive review of the current status and future directions

Takanen

Pinnarò²,

Farina³

et al. 2022

Front. Oncol.

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“…Tümör yatağına referans işaretler uygun şekilde yerleştirilirse, bunlar tedavi sırasında CK Synchrony sistemi ile memenin hareketini izlemek için kullanılabilir. Meme kanserli hastalarda tümör yatağında referans işaretleyici altın klipslerin olması doğru tanımlanmış hedefe SBRT uygulanmasını imkân sağlar 18 . Cyberknife cihazı, 6MV X-ışını üreterek 5 mm ile 60 mm arası değişen farklı kolimatörlerle SBRT tedavilerini yapar.…”

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Parsiyel Meme Işınlamasında Cyberknife Sisteminde Farklı Kolimatörlerle Elde Edilen Stereotaktik Meme Radyoterapisi Sanal Planlarının Karşılaştırılması: Retrospektif Çalışma

SARIBAŞ

Çetintaş

Kurt

et al. 2022

Uludağ Üniversitesi Tıp Fakültesi Dergisi

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Çalışmamızda erken evre meme kanseri tanılı hastalarda hızlandırılmış kısmı meme ışınlamasında (HKMI) CyberKnife (CK) tedavi cihazında yapılan sanal planlarda hedef hacim ve kritik organ dozlarının karşılaştırılması amaçlanmıştır. Birimimizde radyoterapi almış 5 hasta için CyberKnife sisteminde Iris, sabit ve çok yapraklı kolimatör (ÇYK) için günlük 6 Gy toplam 30 Gy olacak şekilde sanal plan oluşturuldu. Üç farklı kolimatör için dozimetrik parametreler NSABP-39/RTOG 0413 protokolündeki kısıtlamalara göre analiz edildi. Planlarda kritik organların korunması ve PTV’ nin reçete edilen dozun % 95’ ini alması sağlandı. Reçete edilen doz minimum % 80’ lik izodoz eğrisine tanımlandı. Homojenite indeksi (Hİ), konformite indeksi (Kİ), tedavi süresi (dk), monitör unit (MU) ve kritik organların aldığı dozlar karşılaştırıldı. Iris, sabit kolimatör, ÇYK için sırasıyla Hİ değerleri ortalama 1,2- 1,2- 1,19, Kİ değerleri ortalama 1,08- 1,06- 1,07 tedavi süresi ortalama 47,6- 52,2- 25,4 (dk) ve MU değerleri ortalama 19736,2- 20267,3- 7161,3 olarak bulunmuştur. Planların karşılaştırılması sonucunda MU, tedavi süresi için anlamlı fark bulunmuştur (p< 0,05). Ortalama MU ve tedavi süresi, en düşük ÇYK’ da bulunmuştur Hİ, Kİ için anlamlı fark bulunmamıştır. Aynı taraf memenin V30 ve V15 değerleri en düşük ÇYK’ da çıkmıştır. Akciğer ve kalp için Dmax değerleri arasında anlamlı bir fark bulunmadı. Sonuç olarak, hedef hacim her kolimatörde istenen dozu almıştır. Karşı meme ve karşı akciğer dozları en düşük Iris’te bulundu. Kalp dozları için sabit kolimatörün daha uygun olduğu bulundu. Fakat bu değerler anlamlı olarak fark yaratmadı. Sabit kolimatörde (52,2 dk), tedavi süresi uzun olduğu için klinik uygulamalarda zorluk çıkarabilir. CyberKnife ile meme SBRT uygulamalarında kolimatör seçimi, tümör boyutu, kritik organlara yakınlık durumu ve tümör lokalizasyonuna bağlı olarak değişebilir.

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Stereoscopic X-ray image and thermo-optical surface guidance for breast cancer radiotherapy in deep inspiration breath-hold

Buschmann,

Kauer-Dorner,

Konrad

et al. 2023

Strahlenther Onkol

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Purpose To investigate the feasibility of a thermo-optical surface imaging (SGRT) system combined with room-based stereoscopic X‑ray image guidance (IGRT) in a dedicated breast deep inspiration breath-hold (DIBH) irradiation workflow. In this context, benchmarking of portal imaging (EPID) and cone-beam CT (CBCT) against stereoscopic X‑rays was performed. Methods SGRT + IGRT data of 30 left-sided DIBH breast patients (1 patient with bilateral cancer) treated in 351 fractions using thermo-optical surface imaging and X-ray IGRT were retrospectively analysed. Patients were prepositioned based on a free-breathing surface reference derived from a CT scan. Once the DIBH was reached using visual feedback, two stereoscopic X‑ray images were acquired and registered to the digitally reconstructed radiographs derived from the DIBH CT. Based on this registration, a couch correction was performed. Positioning and monitoring by surface and X-ray imaging were verified by protocol-based EPID or CBCT imaging at selected fractions and the calculation of residual geometric deviations. Results The median X‑ray-derived couch correction vector was 4.9 (interquartile range [IQR] 3.3–7.1) mm long. Verification imaging was performed for 134 fractions (216 RT field verifications) with EPID and for 37 fractions with CBCT, respectively. The median 2D/3D deviation vector length over all verification images was 2.5 (IQR 1.6–3.9) mm/3.4 (IQR 2.2–4.8) mm for EPID/CBCT, both being well within the planning target volume (PTV) margins (7 mm). A moderate correlation (0.49–0.65) was observed between the surface signal and X-ray position in DIBH. Conclusion DIBH treatments using thermo-optical SGRT and X-ray IGRT were feasible for breast cancer patients. Stereoscopic X‑ray positioning was successfully verified by standard IGRT techniques.

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5-year results of accelerated partial breast irradiation (APBI) with SBRT (stereotactic body radiation therapy) and exactrac adaptive gating (Novalis®) for very early breast cancer patients: was it all worth it?

Cited by 10 publications

References 52 publications

Stereotactic partial breast irradiation in primary breast cancer: A comprehensive review of the current status and future directions

Stereotactic partial breast irradiation in primary breast cancer: A comprehensive review of the current status and future directions

Parsiyel Meme Işınlamasında Cyberknife Sisteminde Farklı Kolimatörlerle Elde Edilen Stereotaktik Meme Radyoterapisi Sanal Planlarının Karşılaştırılması: Retrospektif Çalışma

Stereoscopic X-ray image and thermo-optical surface guidance for breast cancer radiotherapy in deep inspiration breath-hold

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