Accelerated Partial-Breast Intensity-Modulated Radiotherapy Results in Improved Dose Distribution When Compared With Three-Dimensional Treatment-Planning Techniques

Rusthoven, Kyle E.; Carter, Dennis L.; Howell, Kathryn; Kercher, Jane M.; Henkenberns, P.; Hunter, K.U.; Leonard, Charles E.

doi:10.1016/j.ijrobp.2007.08.047

Cited by 59 publications

(45 citation statements)

References 29 publications

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“…A dose of 34 Gy was administered to the initial 7 patients and a dose of 38.5 Gy to the subsequent 98 patients. Additional treatment details have been previously reported (22,23).…”

Section: Methodsmentioning

confidence: 99%

“…Disease-free survival after follow-up of >5 years has been reported in many of these studies (2-4, 7, 9). Accelerated external beam RT has also been investigated in recent studies using either three-dimensional conformal RT (14)(15)(16)(17)(18)(19)(20)(21) or accelerated partial breast intensely-modulated RT (APBIMRT) (22,23). The present study used data from a database of previously planned and treated APBIMRT patients and correlated the treatment parameters with the clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Predictors for Clinical Outcomes After Accelerated Partial Breast Intensity-Modulated Radiotherapy

Reeder

Carter

Howell

et al. 2009

International Journal of Radiation Oncology*Biology*Physics

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“…A dose of 34 Gy was administered to the initial 7 patients and a dose of 38.5 Gy to the subsequent 98 patients. Additional treatment details have been previously reported (22,23).…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predictors for Clinical Outcomes After Accelerated Partial Breast Intensity-Modulated Radiotherapy

Reeder

Carter

Howell

et al. 2009

International Journal of Radiation Oncology*Biology*Physics

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“…There are other doses and treatment schedules that have been recommended and used successfully (Table 6). Some groups have employed 30 Gy in 5 fractions (over 10 days), whereas others have conducted does escalation trials attempting to establish the most appropriate dose (15)(16)(17)(18). The early results in this trial using 38.5 Gy in 10 fractions are encouraging but must be viewed cautiously.…”

Section: Efficacymentioning

confidence: 99%

Initial Efficacy Results of RTOG 0319: Three Dimensional Conformal Radiation Therapy (3D-CRT) Confined to the Region of the Lumpectomy Cavity for Stage I/II Breast Carcinoma

Vicini

Winter

Straube

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

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Purpose-This prospective study (Radiation Therapy Oncology Group 0319) examines the use of three-dimensional conformal external beam radiotherapy (3D-CRT) to deliver accelerated partial breast irradiation (APBI). Initial data on efficacy and toxicity are presented.Methods and Materials-Patients with Stage I or II breast cancer with lesions≤3 cm, negative margins and with≤3 positive nodes were eligible. The 3D-CRT was 38.5 Gy in 3.85 Gy/fraction delivered 2×/day. Ipsilateral breast, ipsilateral nodal, contralateral breast, and distant failure (IBF, INF, CBF, DF) were estimated using the cumulative incidence method. Mastectomy-free, diseasefree, and overall survival (MFS, DFS, OS) were recorded. The National Cancer Institute Common Terminology Criteria for Adverse Events, version 3, was used to grade acute and late toxicity.Results-Fifty-eight patients were entered and 52 patients are eligible and evaluable for efficacy. The median age of patients was 61 years with the following characteristics: 46% tumor size <1 cm; 87% invasive ductal histology; 94% American Joint Committee on Cancer Stage I; 65% postmenopausal; 83% no chemotherapy; and 71% with no hormone therapy. Median follow-up is Conclusions-Initial efficacy and toxicity using 3D-CRT to deliver APBI appears comparable to other experiences with similar follow-up. However, additional patients, further follow-up, and mature Phase III data are needed to evaluate the extent of application, limitations, and value of this particular form of APBI.

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“…As noted above, in this analysis, use of IMRT also resulted in decreased dose to the heart, ipsilateral lung, and ipsilateral breast owing to proper optimization. Similarly, Rusthoven et al [24] showed significant improvement in the volume of ipsilateral lung (V 20Gy(RBE) 1.2% versus 2.3%, P , .01) and heart (V 5Gy(RBE) 0.6% versus 1.7%, P ¼ .04) with the use of IMRT APBI compared to 3DCRT. Harsolia et al [25] also showed that IMRT provides superiority over 3DCRT in breast treatment.…”

Section: Discussionmentioning

confidence: 81%

Dosimetric Comparison of Treatment Techniques: Brachytherapy, Intensity-Modulated Radiation Therapy, and Proton Beam in Partial Breast Irradiation

Hansen¹,

Bartlett²,

Mannina³

et al. 2015

International Journal of Particle Therapy

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Purpose: To perform a dosimetric comparison of 3 accelerated partial breast irradiation techniques: catheter-based brachytherapy (BT), intensity-modulated radiation therapy (IMRT), and proton beam therapy (PBT). Patients and Methods: Twelve patients with left-sided breast cancer treated with SAVI (Strut-Adjusted Volume Implant) were selected in this study. The original BT plans were compared with optimum plans using IMRT and PBT for 34 Gy (RBE) with 1.1 RBE in 10 fractions using identical parameters for target and organs at risk. Results: Significant reduction in maximum dose to the ipsilateral breast was observed with PBT and IMRT (mean 108.58% [PBT] versus 107.78% [IMRT] versus 2194.43% [BT], P ¼ .001 for both PBT and IMRT compared to BT). The mean dose to the heart was 0%, 1.38%, and 3.85%, for PBT, IMRT, and BT, respectively (P , .001 and P ¼ .026). The chest wall mean dose was 10.07%, 14.65%, and 29.44% for PBT, IMRT, and BT, respectively (P ¼ .001 and .013 compared to BT). The PBT was superior in reducing the mean ipsilateral lung dose (mean 0.04% versus 2.13% versus 5.4%, P ¼ .025 and P , .001). There was no statistically significant difference in the maximum dose to the ipsilateral lung, chest wall, 3-mm skin rind or in the mean ipsilateral breast V 50% among the 3 techniques (P ¼ .168, .405, .067, and .780, respectively). PBT exhibited the greatest mean dose homogeneity index of 4.75 compared to 7.18 for IMRT (P ¼ .001) and 195.82 for BT (P , .001). All techniques resulted in similar dose conformality (P ¼ .143). Conclusion: This study confirms the dosimetric feasibility of PBT and IMRT to lower dose to organs at risk while still maintaining high target dose conformality. Though the results of this comparison are promising, continued clinical research is needed to better define the role of PBT and IMRT in the accelerated partial breast irradiation treatment of early-stage breast cancer.

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Accelerated Partial-Breast Intensity-Modulated Radiotherapy Results in Improved Dose Distribution When Compared With Three-Dimensional Treatment-Planning Techniques

Cited by 59 publications

References 29 publications

Predictors for Clinical Outcomes After Accelerated Partial Breast Intensity-Modulated Radiotherapy

Predictors for Clinical Outcomes After Accelerated Partial Breast Intensity-Modulated Radiotherapy

Initial Efficacy Results of RTOG 0319: Three Dimensional Conformal Radiation Therapy (3D-CRT) Confined to the Region of the Lumpectomy Cavity for Stage I/II Breast Carcinoma

Dosimetric Comparison of Treatment Techniques: Brachytherapy, Intensity-Modulated Radiation Therapy, and Proton Beam in Partial Breast Irradiation

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