P67 Breast cancer: External beam radiotherapy and interstitial implantation — 10-year clinical results

Hammer, J.; Track, C.; Seewald, D.H.; Zoidl, J.P.; Labeck, W.; Putz, E.; Gruy, B.

doi:10.1016/s0959-8049(97)89284-2

Cited by 7 publications

(10 citation statements)

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“…More information about this issue is expected from the EORTC trial 22881/10882. At Hammer's institution the "rules" for the boost have changed continuously over the last 15 years: While during the 1980's all patients with breast conservation received an iridium-192 HDR-or an electron boost in the last decade, this has been restricted to patients with particular prognostic criteria [13][14][15]41]. The boost is given in all T2-tumor patients except in quadrantectomies with 1 cm or more tumor free specimen limits.…”

Section: Indications For a Boostmentioning

confidence: 99%

“…In patients without marker clips the use of sonography is recommended to localize the scar inside the breast which is assumed to be the tumor bed. Also CT-scans or MRI-scans [15,33,36] can give more information about the previous tumor location. The presence of a seroma or hematoma makes the localization difficult: is the tumor bed defined by the tissue around the fluid or does the tumor bed lie on one side?…”

Section: The Target Volume -Definition Localization and Sizementioning

confidence: 99%

“…Any fluid (hematoma or seroma) or air (insufflated for localization reasons) in the tumor bed increases the treated volume logarithmically, resulting in an increased risk of late effects [4,14,15,26]. In Table 2 this dramatic increase of volume with linear increase of the radius of the inner sphere (Figure 2) is demonstrated.…”

Section: The Target Volume -Definition Localization and Sizementioning

confidence: 99%

“…The latter method is not only associated with larger treatment volumes resulting in a higher rate of breast fibroses, but also results in an increased rate of telangiectasia due to a higher skin dose [15,40,43,46]. Using the "useful boost range"-concept van Limbergen et al [47] calculated that the critical depth for the target volume from which an interstitial implant has a definitive better ballistic selectivity compared to electron boosts is 28 mm.…”

Section: Choice Between Electron Beams and Interstitial Implantsmentioning

confidence: 99%

“…Assuming an α/β-ratio of 10 for acute reactions this results in 18.6 Gy compared to 2 Gy per day, and assuming an α/β-ratio of 3, this results in 27.6 Gy compared to a fractionation of 2 Gy per day [29,51]. In a report about more than 500 patients with a 10 Gy HDR boost applied in 1 fraction after 45 to 50 Gy external beam radiotherapy to the whole breast [15] the number of acute and late side effects is low after a mean follow-up of 69 months.…”

Section: Radiation Dose and Dose Ratementioning

confidence: 99%

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Breast Boost – Why, How, When ...?

1999

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More information about the indication for a boost is to be expected from the EORTC trial 22881/10882. Careful selection of treatment procedures for specific subgroups of patients and refinement in surgical procedures and radiotherapy techniques may be useful in improving the clinical and cosmetic results in breast conservation therapy. Prospective trials comparing on the one hand different boost techniques and on the other hand particular morphologic criteria in treatments with boost and without boost are needed to give more detailed recommendations for boost indications and for boost techniques.

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Section: Indications For a Boostmentioning

confidence: 99%

Section: The Target Volume -Definition Localization and Sizementioning

confidence: 99%

Section: The Target Volume -Definition Localization and Sizementioning

confidence: 99%

Section: Choice Between Electron Beams and Interstitial Implantsmentioning

confidence: 99%

Section: Radiation Dose and Dose Ratementioning

confidence: 99%

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Breast Boost – Why, How, When ...?

1999

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Contemporary role of modern brachytherapy techniques in the management of malignant thoracic tumors

Harms¹,

Becker²,

Krempien³

et al. 2001

Seminars in Surgical Oncology

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Sole brachytherapy for carcinoma of the lung is most often performed using high-dose-rate (HDR) remote afterloading equipment, which delivers the treatment within the tracheobronchial tree in an outpatient setting. It provides excellent, rapid palliation in advanced stages, and can also be used selectively for curative intent in early stages. In better-performance patients, fractionated external beam radiation therapy (EBRT) is preferred to brachytherapy as an initial treatment because it appears to provide a modest gain in survival, and more sustained palliation. In patients with centrally located tumors and limited extent of disease, the combination of external and endoluminal irradiation enables curative treatment options. Intraoperative brachytherapy may complement standard adjuvant treatment in incompletely resected, unresectable, or medically inoperable patients, and has the potential to improve local control in selected cases. Due to the rarity of the disease, the role of endoluminal brachytherapy in the treatment regimen of tracheal neoplasms is not yet clearly defined. The risk of fatal bleeding after endoluminal brachytherapy appears to be correlated with tumor localization and fraction size, but in the majority of cases fatal bleeds are caused by progression of local disease. The use of a distanceable applicator provides a central positioning of the source, prevents the delivery of high-contact doses to the mucosa, and may reduce toxicity. The standard technique for interstitial brachytherapy after breast-conserving surgery and adjuvant EBRT is the use of low-dose-rate (LDR) brachytherapy, but it may also be applied by means of pulsed-dose-rate (PDR) or HDR techniques. Prospective trials comparing different boost techniques and indications are needed to define more precisely the subgroup of patients who are most suitable for interstitial brachytherapy. Reirradiation of chest wall local recurrences using brachytherapy molds is effective and provides a high local control rate with acceptable toxicity.

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Placing the Boost in Breast-conservation Radiotherapy: A Review of the Role, Indications and Techniques for Breast-boost Radiotherapy

Graham

2006

Clinical Oncology

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P67 Breast cancer: External beam radiotherapy and interstitial implantation — 10-year clinical results

Cited by 7 publications

References 0 publications

Breast Boost – Why, How, When ...?

Breast Boost – Why, How, When ...?

Contemporary role of modern brachytherapy techniques in the management of malignant thoracic tumors

Placing the Boost in Breast-conservation Radiotherapy: A Review of the Role, Indications and Techniques for Breast-boost Radiotherapy

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