Five year outcomes of hypofractionated simultaneous integrated boost irradiation in breast conserving therapy; patterns of recurrence

Bantema-Joppe, Enja J.; Vredeveld, Eline J.; Bock, Geertruida H. de; Busz, D.; Iersel, M. Woltman-van; Dolsma, W.V.; Laan, Hans Paul van der; Langendijk, Johannes A.; Maduro, John H.

doi:10.1016/j.radonc.2013.08.037

Cited by 35 publications

(23 citation statements)

References 10 publications

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“…3-year locoregional control, recurrence-free survival, and OS rates were 99.2, 95.5, and 97.1%, respectively. 5-year local control was 98.9% [36]. Regarding toxicity and cosmetic outcome, after a median follow-up time of 30 months (range 6-54 months), 8.5% of patients had ≥ G2 fibrosis in the boost area, chest wall pain was detected in 6.7%, and teleangiectasia was detected in 3.7% (≥ G2) [37].…”

Section: Boosting the Tumor Bedmentioning

confidence: 99%

Tumor Bed Boost Integration during Whole Breast Radiotherapy: A Review of the Current Evidence

et al. 2014

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Radiation therapy delivered with hypofractionation, which involves the delivery of a higher dose per fraction in fewer fractions (generally with a lower total nominal dose) over a shorter overall treatment time, is an established therapeutic option at least for a selected group of early breast cancer patients after breast-conserving surgery. Optimal delivery of the tumor bed boost dose in terms of timing, fractionation, and total dose whenever a hypofractionated schedule is employed has yet to be established. We herein present a review of the current evidence on the role of boost integration in whole breast radiotherapy.

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Section: Boosting the Tumor Bedmentioning

confidence: 99%

Tumor Bed Boost Integration during Whole Breast Radiotherapy: A Review of the Current Evidence

et al. 2014

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“…A few planning studies include right sided as well as left sided breast cancer [8–10], but dedicated planning studies for right sided breast cancer seemed not to be of interest up to now. During the last years, however, simultaneous integrated boost radiation therapy superseded sequential boost therapy as the standard fractionation scheme [12, 13]. In this case, IMRT and VMAT have shown advantages in target coverage and sparing of the organs at risk (OAR) as compared to 3D-CRT techniques [10, 14], thus becoming more important also for right sided breast cancer.…”

Section: Introductionmentioning

confidence: 99%

Simultaneous integrated boost (SIB) radiation therapy of right sided breast cancer with and without flattening filter - A treatment planning study

et al. 2016

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BackgroundThe aim of the study was to compare the two irradiation modes with (FF) and without flattening filter (FFF) for three different treatment techniques for simultaneous integrated boost radiation therapy of patients with right sided breast cancer.MethodsAn Elekta Synergy linac with Agility collimating device is used to simulate the treatment of 10 patients. Six plans were generated in Monaco 5.0 for each patient treating the whole breast and a simultaneous integrated boost (SIB) volume: intensity modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT) and a tangential arc VMAT (tVMAT), each with and without flattening filter. Plan quality was assessed considering target coverage, sparing of the contralateral breast, the lungs, the heart and the normal tissue. All plans were verified by a 2D-ionisation-chamber-array and delivery times were measured and compared. The Wilcoxon test was used for statistical analysis with a significance level of 0.05.ResultsSignificantly best target coverage and homogeneity was achieved using VMAT FFF with V95% = (98.7 ± 0.8) % and HI = (8.2 ± 0.9) % for the SIB and V95% = (98.3 ± 0.7) % for the PTV, whereas tVMAT showed significantly lowest doses to the contralateral organs at risk with a Dmean of (0.7 ± 0.1) Gy for the contralateral lung, (1.0 ± 0.2) Gy for the contralateral breast and (1.4 ± 0.2) Gy for the heart. All plans passed the gamma evaluation with a mean passing rate of (99.2 ± 0.8) %. Delivery times were significantly reduced for VMAT and tVMAT but increased for IMRT, when FFF was used. Lowest delivery times were observed for tVMAT FFF with (1:20 ± 0:07) min.ConclusionBalancing target coverage, OAR sparing and delivery time, VMAT FFF and tVMAT FFF are considered the preferable of the investigated treatment options in simultaneous integrated boost irradiation of right sided breast cancer for the combination of an Elekta Synergy linac with Agility and the treatment planning system Monaco 5.0.

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“…Early-stage breast cancer is treated with different modalities and may consist of surgery, radiotherapy and systemic treatment, including chemotherapy, endocrine treatment and targeted agents. The addition of these various treatment modalities improved treatment outcome significantly in terms of overall survival ( Early Breast Cancer Trialists' Collaborative Group (EBCTCG) et al , 2011) , with 5-year survival rates for stage I–II of >92% ( Bantema-Joppe et al , 2013 ; Netherlands Cancer Registry, 2014a , 2014b ).…”

mentioning

confidence: 99%

The impact of age on changes in quality of life among breast cancer survivors treated with breast-conserving surgery and radiotherapy

et al. 2015

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Background:The purpose of the study was to determine the impact of young age on health-related quality of life (HRQoL) by comparing HRQoL of younger and older breast cancer patients, corrected for confounding, and of young patients and a general Dutch population.Methods:The population consisted of breast cancer survivors (stage 0-III) after breast-conserving surgery and radiotherapy. Health-related quality of life was prospectively assessed using the EORTC QLQ-C30 and QLQ-BR23 questionnaires. The association between age (⩽50; 51–70; ⩾70 years) and HRQoL over time was analysed with mixed modelling. The clinical relevance of differences between/within age groups was estimated with Cohen's D and consensus-based guidelines. The HRQoL data from the young patient cohort were compared with Dutch reference data at 3 years after radiotherapy.Results:A total of 1420 patients completed 3200 questionnaires. Median follow-up was 34 (range 6–70) months. Median age was 59 (range 28–85) years. Compared with older subjects, young women reported worse HRQoL in the first year after radiotherapy, but clinical relevance was limited. Three years after radiotherapy, HRQoL values in the younger group were equal to those in the reference population. Pain and fatigue after radiotherapy improved, with medium clinical relevance.Conclusions:Three years after radiotherapy for breast cancer, young age was not a risk factor for decreased HRQoL.

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Five year outcomes of hypofractionated simultaneous integrated boost irradiation in breast conserving therapy; patterns of recurrence

Cited by 35 publications

References 10 publications

Tumor Bed Boost Integration during Whole Breast Radiotherapy: A Review of the Current Evidence

Tumor Bed Boost Integration during Whole Breast Radiotherapy: A Review of the Current Evidence

Simultaneous integrated boost (SIB) radiation therapy of right sided breast cancer with and without flattening filter - A treatment planning study

The impact of age on changes in quality of life among breast cancer survivors treated with breast-conserving surgery and radiotherapy

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