Comparison of Photon with Electron Boost in Treatment of Early Stage Breast Cancer

Kov́acs, Árṕad; Hadjiev, Janaki; Lakosi, Ferenc; Glavák, Csaba; Antal, Gergely; Bogner, Péter; Horváth, Ákos G.; Romics, Imre

doi:10.1007/s12253-008-9015-2

Cited by 15 publications

(9 citation statements)

References 23 publications

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“…Good and excellent cosmetic scores were observed in 80% patients of both arms at the end of 2 years. Similar results were observed by Kovacs et al, in the above study, [28] in which they reported good and excellent cosmetic scores in 88.3% and fair cosmetic score in 11.6% of 3DCRT photon boost patients at the end of 4 years follow-up. Thus, indicating the fact that breast cosmesis improves with time, post-radiation, and better appreciated in long-term follow up studies.…”

Section: Discussionsupporting

confidence: 91%

Clinical and cosmetic results of breast boost radiotherapy in early breast cancer: A randomized study between electron and photon

et al. 2014

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Both electrons and 3DCRT can be used for boost planning to the tumor bed in post-lumpectomy patients. Though there was slightly increased acute skin toxicity with 3DCRT photon which led to interruption of therapy, overall cosmesis at 2 years is similar in both modalities. 3DCRT boost is a better option than electrons dosimetrically, considering the fact that conformality; PTV coverage and OAR dosimetry were superior with photons. Thus in centers where electron beam therapy is not available, 3DCRT photon can be used effectively for tumor bed boost.

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Section: Discussionsupporting

confidence: 91%

Clinical and cosmetic results of breast boost radiotherapy in early breast cancer: A randomized study between electron and photon

et al. 2014

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“…Multiple studies have shown the high likelihood of missing the true peri-lumpectomy target volume when clinical localization focusing on the scar is used [3,4,15]. In our previous planning study [13] we demonstrated that 3D CT based photon boost technique gives better coverage to the tumor bed and higher conformality compared to electron boost and for the superficial targets (tumor bed-skin distance 1 cm to 2 cm) photon boost seems to be the better choice.…”

Section: Discussionmentioning

confidence: 91%

3-D Conformal Photon Boost in the Treatment of Early Stage Breast Cancer: Four Year Follow Up Results

Kov́acs

Lakosi

Liposits

et al. 2010

Pathol. Oncol. Res.

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In the treatment of early stage breast cancer, breast conserving surgery (BCS) followed by whole breast irradiation (WBI) is the standard treatment. The impact of the tumor bed boost following WBI is well-defined, but there are various delivery methods. In this study we demonstrate our 4 year experience with the 3-D conformal boost technique. Between January 2004 and June 2005, 77 early stage (Stage I-II) breast cancer patients were treated in our institute with whole breast irradiation (WBI, 50.4 Gy in 28 fractions) after breast conserving surgery. Following WBI, 3-D conformal photon boost was delivered (10-16 Gy in five to eight fractions) for all patients. The clinical outcome was retrospectively recorded in terms of survival and local control. The side effect profile (fibrosis, fat necrosis and cosmetic outcome) was also recorded and studied. In our patient group the mean follow up time was 46.8 months (median: 52, range: 17-71, SD: 14.4) The 4-year probability of local tumor control was 96% (crude rate: 74/77-96.1%), the 4-year probability of overall survival was 96% (crude rate: 74/77-96.1%) in this patient group. In case of the distant metastasis free survival the probability was 89, 5% (crude rate: 70/77-90, 1%). Probability of disease specific survival was 98% (crude rate: 76/77-98. 7%). Local relapse occurred in three cases (3.9%). In ten cases (12.9%) asymptomatic grade I-II breast fibrosis, in eight cases (10.4%) asymptomatic breast fat necrosis were registered. For 14 patients (18.2%) asymptomatic lung fibrosis was recorded on the control CT scans. In term of the relapse free survival, the close resection margin and the nodal positivity resulted in significant difference in favor of the clear resection margin group and the node negative group. In this study the 3-D conformal photon boost resulted in good local control and side effect profile. The presence of tumor bed clips resulted in significantly lower boost PTV volumes, but no correlation was found between the irradiated boost volume and the breast fibrosis. In the relapse free survival analysis, nodal negativity and clear margin status resulted in significantly better RFS.

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“…However, the limitations of single-field EB plans have been reported by several investigators [8-10]. Kovacs et al [8] reported that EB plans were inferior to XB plans in terms of target coverage and conformity. Toscas et al [9] reported that only superficial tumors could be optimally treated with EB plans.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Electron and X-Ray Beams for Tumor Bed Boost Irradiation in Breast-Conserving Treatment

Park

Kim

2013

J Breast Cancer

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PurposeThis study aimed to compare the dosimetric profiles of electron beams (EB) and X-ray beams (XB) for boosting irradiation in breast cancer patients who underwent breast-conserving surgery and postoperative radiotherapy.MethodsFor 131 breast cancer patients who underwent breast-conserving surgery, we compared plans for EB and XB boost irradiation after whole-breast irradiation. The organs at risk (OAR) included the cardiac chambers, coronary arteries, ipsilateral lung, and skin. The conformity index (CI), inhomogeneity index (IHI), and dose-volume parameters for the planning target volume (PTV), and OAR were calculated. Postradiotherapy chest computed tomography scans were performed to detect radiation pneumonitis.ResultsXB plans showed a significantly better CI and IHI for the PTVs, compared to the EB plans. Regarding OAR sparing, the XB reduced the high-dose volume at the expense of an increased low-dose volume. In 33 patients whose radiation fields included nipples, IHI was higher in the EB plans, whereas the presence of a nipple in the radiation field did not interfere with the XB. EB-treated patients developed more subclinical radiation pneumonitis.ConclusionXB plans were superior to EB plans in terms of PTV coverage (homogeneity and conformity) and high-dose volume sparing in OAR when used as boost irradiation after breast-conserving surgery. A disadvantage of the XB plan was an increased low-dose volume in the OAR, but this was offset by the increased electron energy. Consequently, tailored plans with either XB or EB are necessary to adapt to patient anatomic variance and tumor bed geometric properties.

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Comparison of Photon with Electron Boost in Treatment of Early Stage Breast Cancer

Cited by 15 publications

References 23 publications

Clinical and cosmetic results of breast boost radiotherapy in early breast cancer: A randomized study between electron and photon

Clinical and cosmetic results of breast boost radiotherapy in early breast cancer: A randomized study between electron and photon

3-D Conformal Photon Boost in the Treatment of Early Stage Breast Cancer: Four Year Follow Up Results

Comparison of Electron and X-Ray Beams for Tumor Bed Boost Irradiation in Breast-Conserving Treatment

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