Recommendations from GEC ESTRO Breast Cancer Working Group (I): Target definition and target delineation for accelerated or boost Partial Breast Irradiation using multicatheter interstitial brachytherapy after breast conserving closed cavity surgery

Strnad, Vratislav; Hannoun‐Lévi, Jean‐Michel; Guinot, J.L.; Lössl, Kristina; Kauer-Dorner, Daniela; Resch, Alexandra; Kovács, György; Major, Tibor; Limbergen, Erik

doi:10.1016/j.radonc.2015.06.010

Cited by 117 publications

(67 citation statements)

References 55 publications

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“…[13,14] Alco et al have shown that CTV BV dosage conformities change vary with the number of clips. [15] However, Kirwan et al have found that clips are not implanted for more than one-third of patients, in spite of benefits that have been demonstrated.…”

Section: Discussionmentioning

confidence: 99%

Does Preoperative Positron Emission Tomography Help Delineate the Boost Volume After Oncoplastic Surgery for Breast Cancer?

Altinok¹

2017

TJ Oncol

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OBJECTIVEThe tumor bed within the breast shifts during oncoplastic surgery (OPS) for breast cancer (BC). Preoperative imagery is used to determine the boost volume (BV) for patients not implanted with surgical clips. This prospective study was conducted to geometrically compare BVs determined using preoperative imagery and BVs determined utilizing surgical clips. METHODSPatients diagnosed with BC were scanned using PET-CT during 2013-2015. Twenty patients who had undergone OPS but who did not have metastasis underwent CT prior to radiotherapy. Their preoperative images were fused with planning CT images. The tumor volume (CTVboost-pet), as determined from the preoperative PET-CT images, was contoured. Next, CTVboost-clips was determined using surgical clips. Geometric relationships between these two volumes were statistically compared. RESULTSPlanar projections of CTVboost-pet and CTVboost-clips were evaluated. Displacements between CTVboost-pet and CTVboost-clips in the axial (XZ) and coronal (XY) planes were 1.17 cm (min-max: 0.03-3.64 cm) and 1.67 cm (min-max: 0.38-4.14 cm), respectively, and were statistically significant (p<0.001), whereas the displacement in the sagittal (YZ) plane was 1.07 cm (min-max: 0.04-4.45 cm) and was not significant (p>0.7). CONCLUSIONPreoperative imaging alone was not reliable when determining the BV in patients who had undergone OPS and had no clips. Large PTV margins can be an option to overcome this issue. Surgical clips need to be inserted during OPS.

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Section: Discussionmentioning

confidence: 99%

Does Preoperative Positron Emission Tomography Help Delineate the Boost Volume After Oncoplastic Surgery for Breast Cancer?

Altinok¹

2017

TJ Oncol

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“…Inclusion criteria, according to the Groupe Européen de Curiethérapie and the European Society for Radiotherapy & Oncology (GEC-ESTRO) recommendations on patient selection for APBI of low and intermediate risk groups were as follows: age ≥ 40 years, tumor size by final pathology ≤ 3 cm, negative axillary lymph nodes (sentinel or dissection), microscopically negative or close (≤ 2 mm) surgical margins, invasive ductal or lobular carcinoma, unicentric/unifocal tumors. Exclusion criteria consisted of younger age, tumors more than 3 cm in size, positive margins (presence of tumor tissue on surgical margins), axillary lymph nodes’ metastasis, presence of extensive intraductal component, multicentric/multifocal tumors [24, 25, 26, 27, 28]. All patients have signed informed consent before the treatment.…”

Section: Methodsmentioning

confidence: 99%

“…Target definition and delineation was done according GEC-ESTRO Breast Cancer Working Group recommendations [26]. Post implantation CT images were transferred to BrachyVision treatment planning system (Varian Medical Systems, Inc., Palo Alto, CA, USA), on which the target volume segmentation and planning was performed.…”

Section: Methodsmentioning

confidence: 99%

High-dose-rate interstitial brachytherapy for accelerated partial breast irradiation – trial results of Azerbaijan National Center of Oncology

Aliyev¹,

Isayev²,

Akbarov³

et al. 2017

jcb

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PurposeTo describe early results of two cohorts of patients with low and intermediate risk of early breast cancer treated with accelerated partial breast irradiation (APBI) using different schedules of multicatheter brachytherapy.Material and methodsPatients with early stage breast cancer after breast conserving surgery were enrolled for a prospective analysis. The APBI, using multicatheter brachytherapy, was delivered either eight times 4 Gy in five days with a planned total dose of 32 Gy, or seven times 5 Gy in four days with a planned total dose of 35 Gy. Primary endpoints were side effects.ResultsForty-eight patients were enrolled between 2012 and 2014. Patients characteristics were as follow: median age of patients was 55 years, early breast cancer was defined according GEC-ESTRO recommendations. With a median follow-up period of 37 months, no significant differences regarding late side effects and cosmesis between two cohorts of patients were documented. In total, cosmesis was excellent in 13/48 (27.1%) patients, good in 34/48 (70.8%) patients, and moderate in 1/48 patient (2.1%).ConclusionsAccelerated partial breast irradiation using multicatheter brachytherapy with 32 Gy/8 fractions and 35 Gy/7 fractions for early breast cancer seems to be similar in terms of late side effects. According to our findings, APBI was also feasible for intermediate-risk of early breast cancer patients.

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“…It is worth to mention that BT plays an important role in treating elderly patients, particularly unfit, frail, or sarcopenic, in which a conservative therapeutic approach may be the best choice [15]. Analyzing the international scenario in terms of cultural background, it becomes clear that there is an adequate attention and consideration towards BT, supported by the presence of dedicated guidelines, with regard to several anatomical sites issued by the main European [16,17,18,19,20,21,22,23,24,25] and American societies [26,27,28]. For this reason, it is sensible to correlate the cultural diffusion of the role and importance of BT at a national level, with its actual diffusion in the clinical practice [29,30,31,32,33,34,35,36,37,38].…”

Section: Airo Interventional Radiotherapy Study Group "State Of the Amentioning

confidence: 99%

Can brachytherapy be properly considered in the clinical practice? Trilogy project: The vision of the AIRO (Italian Association of Radiotherapy and Clinical Oncology) Interventional Radiotherapy study group

Tagliaferri¹,

Vavassori²,

Lancellotta³

et al. 2020

jcb

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Purpose: Brachytherapy (BT, interventional radiotherapy-IRT) is a kind of radiation therapy, in which the radioactive source is placed nearby or even inside the cancer itself. Even though this kind of radiation therapy appears effective and valuable, BT has been facing a slow but progressive decline over the past decades in Europe, particularly in Italy. Aims of this study were to identify the practical and theoretical reasons why BT is facing a slow decline in Italy, and to define a vision of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) and a strategy about this emerged issues. Material and methods: A programmatic path divided into three steps like a trilogy was launched by AIRO Interventional Radiotherapy study group. The study group performed an initial data collection to highlight both the clinical and the educational topics and problems through specific surveys. After having analyzed the results of the surveys and shared a vision about the emerged issues, a specific strategy was adopted. Results: Four relevant domains were identified and for each ones, a strategy has been discussed and defined. This manuscript shows in detail the individual actions defined (accomplished or in progress). Conclusions: The AIRO vision implies that specific strategic interventions must be carried out in the field of national guidelines, education, research, and communication with patients and colleagues of other specialties in an interdisciplinary setting.

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Recommendations from GEC ESTRO Breast Cancer Working Group (I): Target definition and target delineation for accelerated or boost Partial Breast Irradiation using multicatheter interstitial brachytherapy after breast conserving closed cavity surgery

Cited by 117 publications

References 55 publications

Does Preoperative Positron Emission Tomography Help Delineate the Boost Volume After Oncoplastic Surgery for Breast Cancer?

Does Preoperative Positron Emission Tomography Help Delineate the Boost Volume After Oncoplastic Surgery for Breast Cancer?

High-dose-rate interstitial brachytherapy for accelerated partial breast irradiation – trial results of Azerbaijan National Center of Oncology

Can brachytherapy be properly considered in the clinical practice? Trilogy project: The vision of the AIRO (Italian Association of Radiotherapy and Clinical Oncology) Interventional Radiotherapy study group

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