The impact of the use of intraoperative radiotherapy on costs, travel time and distance for women with breast cancer in the Mexico City Metropolitan Area

2017 ◽  
Vol 116 (6) ◽  
pp. 683-689 ◽  
Author(s):  
Juan Enrique Bargallo-Rocha ◽  
Enrique Soto-Perez-de-Celis ◽  
Francisco Javier Picó-Guzmán ◽  
Carlos Eduardo Quintero-Rodríguez ◽  
David Almog ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Travel Time ◽  
Mexico City ◽  
Metropolitan Area ◽  
Intraoperative Radiotherapy ◽  
The Impact

scholarly journals The Effect of Intraoperative Radiotherapy on Breast Cancer: Focus on the Levels of Angiogenic Factors

2021 ◽  
Author(s):  
Nahid Nafisi ◽  
Maryam Mohammadlou ◽  
Mohammad Esmaeil Akbari ◽  
Seyed Rabie Mahdavi ◽  
Maryam Sheikh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Linear Regression Analysis ◽  
Intraoperative Radiotherapy ◽  
Angiogenic Factors ◽  
Breast Cancer Patients ◽  
Risk Of Death ◽  
Post Surgery ◽  
Before And After ◽  
The Impact

Abstract Objective: Angiogenesis is one of the hallmarks of cancers that is involved in tumor progression. Angiogenic factors induce the formation of new blood vessels and tumor extension, and finally reduce the survival of patients. Intraoperative radiotherapy (IORT), in which radiation is delivered to the tumor bed can kill cells and change tumor microenvironment. Here, we compared the impact of IORT on the levels of angiogenic factors in the blood and surgical wound fluids (SWF) of the breast cancer patients. Patients and Methods: Blood and drained wound fluid (WF) samples were collected from the breast cancer patients before and after surgery, followed by quantification of the amounts of TGF-β, EGF, FGF, VEGF and DLL4 in the patients using ELISA.Results: Our results were indicative of significant differences between the pre-surgery and post-surgery serum levels of EGF, DLL4 and VEGF. In addition, linear regression analysis showed the significant impact of IORT, vascular invasion and lymph node (LN) involvement on the difference between TGF-β levels in the blood before and after surgery-IORT. According to the outcomes of multivariate analysis, IORT changed the levels of EGF and FGF in the blood and WF. Furthermore, logistic regression analyses showed that TGF-β and EGF can be used as predictor markers of the late-stage and LN involvement of the disease. Interestingly, IORT was able to reduce the risk of death and the recurrence rate of disease. Conclusions: In summary, IORT is a safe and effective treatment that can affect angiogenesis and improve the survival of breast cancer patients.

scholarly journals Impact of primary formaldehyde on air pollution in the Mexico City Metropolitan Area

2009 ◽  
Vol 9 (7) ◽  
pp. 2607-2618 ◽  
Author(s):  
W. Lei ◽  
M. Zavala ◽  
B. de Foy ◽  
R. Volkamer ◽  
M. J. Molina ◽  
...  
Keyword(s):  
Mexico City ◽  
Metropolitan Area ◽  
Atmospheric Chemistry ◽  
Transport Model ◽  
Ambient Air ◽  
Urban Atmosphere ◽  
Chemical Transport Model ◽  
Early Afternoon ◽  
Ambient Concentration ◽  
The Impact

Abstract. Formaldehyde (HCHO) is a radical source that plays an important role in urban atmospheric chemistry and ozone formation. The Mexico City Metropolitan Area (MCMA) is characterized by high anthropogenic emissions of HCHO (primary HCHO), which together with photochemical production of HCHO from hydrocarbon oxidation (secondary HCHO), lead to high ambient HCHO levels. The CAMx chemical transport model was employed to evaluate the impact of primary HCHO on its ambient concentration, on the ROx radical budget, and on ozone (O3) formation in the MCMA. Important radical sources, including HCHO, HONO, and O3-olefin reactions, were constrained by measurements from routine observations of the local ambient air monitoring network and the MCMA-2003 field campaign. Primary HCHO was found not only to contribute significantly to the ambient HCHO concentration, but also to enhance the radical budget and O3 production in the urban atmosphere of the MCMA. Overall in the urban area, total daytime radical production is enhanced by up to 10% and peak O3 concentration by up to 8%; moreover primary HCHO tends to make O3 both production rates and ambient concentration peak half an hour earlier. While primary HCHO contributes predominantly to the ambient HCHO concentration between nighttime and morning rush hours, significant influence on the radical budget and O3 production starts early in the morning, peaks at mid-morning and is sustained until early afternoon.

scholarly journals The Composition of Surgical Wound Fluids from Breast Cancer Patients is Affected by Intraoperative Radiotherapy Treatment and Depends on the Molecular Subtype of Breast Cancer

Cancers ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 11 ◽  
Author(s):  
Katarzyna Kulcenty ◽  
Igor Piotrowski ◽  
Joanna Patrycja Wróblewska ◽  
Janusz Wasiewicz ◽  
Wiktoria Maria Suchorska
Keyword(s):  
Breast Cancer ◽  
Wound Healing ◽  
Molecular Subtype ◽  
Breast Cancer Subtype ◽  
Healing Process ◽  
Intraoperative Radiotherapy ◽  
Wound Healing Process ◽  
Surgical Wound ◽  
Luminal A ◽  
The Impact

Invasive oncological procedures affect the remaining tumor cells by increasing their survival, proliferation, and migration through the induction of wound healing response. The phenomena of local relapse after breast-conserving surgery (BCS) has resulted in a series of research and clinical trials with the aim of assessing whether localized intraoperative radiotherapy (IORT), may be beneficial in inhibiting local recurrences. Therefore, it is essential to assess the impact of intraoperative radiotherapy in modulating the immunological response and wound healing process. Thus, we decided to perform a quantitative analysis of the composition of surgical wound fluids (SWF) in two groups of breast cancer (BC) patients: those treated with BCS followed by IORT, and those who underwent BCS alone. We found that several cytokines, which are believed to have anti-tumor properties, were highly expressed in the luminal A breast cancer subtype in the IORT treatment group. Interestingly, we also found significant differences between IORT patients with tumors of different molecular subtypes. Based on these findings, we hypothesized that IORT treatment might be beneficial in changing the tumor bed microenvironment, making it less favorable for tumor recurrence due to decreased concentration of tumor-facilitating cytokines, especially in the luminal A subtype of BC.

scholarly journals Accelerated Partial Breast Irradiation: A New Standard of Care?

Breast Care ◽  
2020 ◽  
Vol 15 (2) ◽  
pp. 136-147
Author(s):  
Tobias Forster ◽  
Clara Victoria Katharina Köhler ◽  
Jürgen Debus ◽  
Juliane Hörner-Rieber
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Side Effects ◽  
Intraoperative Radiotherapy ◽  
Accelerated Partial Breast Irradiation ◽  
Partial Breast Irradiation ◽  
Breast Irradiation ◽  
The Impact

Background: Breast-conserving therapy including lumpectomy and adjuvant whole breast irradiation (WBI) has become the standard therapy for early-stage breast cancer (EBC). Without WBI, the recurrence rate is significantly increased. However, when selecting patients at a low a priori risk of local recurrence only a small breast-cancer-specific mortality benefit, but no overall survival improvement, was detected for WBI. As most recurrences occur close to the lumpectomy cavity, accelerated partial breast irradiation (APBI) delivered exclusively to a limited volume of tissue around the initial lumpectomy site, has gained increased attention and is now discussed as an alternative to WBI for selected EBC patients. Summary: Numerous techniques for APBI (interstitial brachytherapy, external beam-based APBI, intraoperative radiotherapy, MR-guided radiotherapy) allow treatment delivery in a shorter period of time, and radiation oncologists expect to further reduce side effects by using these new techniques, with improvements in cosmetics and quality of life. In this review, we aim to describe the existing evidence for the feasibility and effectiveness of different APBI techniques used in modern radiotherapy. Key Messages: APBI has provided outcomes similar to WBI combined with potentially reduced toxicity. While appropriate patient selection persists to be crucial for acceptable recurrence rates, the precise definition of patients suitable for APBI remains a matter of discussion. As long-term data are often still lacking, special attention should be paid to late side effects and long-term outcomes. Decision-making on appropriate treatment techniques should take into account not only local control rates, but also the impact on the patient’s quality of life.

scholarly journals Impact of primary formaldehyde on air pollution in the Mexico City Metropolitan Area

2008 ◽  
Vol 8 (6) ◽  
pp. 19605-19635 ◽  
Author(s):  
W. Lei ◽  
M. Zavala ◽  
B. de Foy ◽  
R. Volkamer ◽  
M. J. Molina ◽  
...  
Keyword(s):  
Mexico City ◽  
Metropolitan Area ◽  
Atmospheric Chemistry ◽  
Transport Model ◽  
Monitoring Network ◽  
Ambient Air ◽  
Urban Atmosphere ◽  
Chemical Transport Model ◽  
Early Afternoon ◽  
The Impact

Abstract. Formaldehyde (HCHO) is a radical source that plays an important role in urban atmospheric chemistry and ozone formation. The Mexico City Metropolitan Area (MCMA) is characterized by high anthropogenic emissions of HCHO (primary HCHO), which together with photochemical production of HCHO from hydrocarbon oxidation (secondary HCHO), lead to high ambient HCHO levels. The CAMx chemical transport model was employed to evaluate the impact of primary HCHO on its ambient concentration, on the ROx radical budget, and on ozone (O3) formation in the MCMA. Important radical sources, including HCHO, HONO, and O3-olefin reactions, were constrained by measurements from routine observations of the local ambient air monitoring network and the MCMA-2003 field campaign. Primary HCHO was found not only contributing significantly to the ambient HCHO concentration, but also enhancing the radical budget and O3 production in the urban atmosphere of the MCMA. Overall in the urban area, total daytime radical production is enhanced by up to 10% and peak O3 concentration by up to 8%. While primary HCHO contributes predominantly to the ambient HCHO concentration between nighttime and morning rush hours, significant influence on the radical budget and O3 production starts early morning, culminates at mid-morning and is sustained until early afternoon.

scholarly journals Differences of job accessibility among formal and total employment and among car and public transit in the Mexico City Metropolitan Area. Exploring two models based on travel time

2020 ◽  
Author(s):  
Dorian Bautista-Hernández ◽  
Manuel Suárez Lastra
Keyword(s):  
Travel Time ◽  
Mexico City ◽  
Metropolitan Area ◽  
Public Transit ◽  
Total Employment ◽  
Job Accessibility

Este artículo proyecto estudia el patrón de variaciones espaciales de accesibilidad laboral en el Área Metropolitana de la Ciudad de México. Se evalúan las diferencias en la accesibilidad al empleo de acuerdo con el modo de transporte (automóvil o transporte público) utilizado y entre el sector de empleo formal y el empleo total (sectores formal + informal). Se exploraron dos indicadores: la accesibilidad laboral basada en la gravedad y el indicador desarrollado por Shen (1998). Se exploraron dos fuentes de datos del tiempo de viaje: la Encuesta de destinos de origen de hogares 2017 y el modelo de demanda de viajes de la región, TRANUS. El paisaje de accesibilidad resultante se comparó con la estructura urbana citada en la literatura. Los resultados muestran que las áreas con mayor accesibilidad laboral están dentro de la aglomeración central y los corredores asociados a lo largo de las carreteras principales en sus perímetros, de acuerdo con la estructura urbana reportada por Suárez y Delgado (2009). El empleo total aumentó enormemente las oportunidades de empleo, aumentando así la accesibilidad. Los desplazamientos en automóvil reducen el tiempo de viaje, y aunque esto aumenta la accesibilidad en general, el aumento es insignificante cuando se hacen comparaciones con la mayor la accesibilidad entre el empleo formal y total o con la diferencia entre los extremos superior e inferior de la accesibilidad laboral por el transporte público en las Zonas de Análisis de Tráfico. Estas comparaciones han demostrado que, a diferencia del tiempo de viaje, los lugares de residencia y empleo fueron los factores principales que afectaron el acceso al empleo.

scholarly journals Sole adjuvant intraoperative breast radiotherapy in Taiwan: a single-center experience

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Hsin-Yi Yang ◽  
Chi-Wen Tu ◽  
Chien-Chin Chen ◽  
Cheng-Yen Lee ◽  
Yu-Chen Hsu
Keyword(s):  
Breast Cancer ◽  
Adjuvant Radiotherapy ◽  
Locoregional Recurrence ◽  
External Beam Radiotherapy ◽  
Significant Risk ◽  
Intraoperative Radiotherapy ◽  
Breast Cancer Patients ◽  
Clinicopathologic Characteristics ◽  
Oncological Outcomes ◽  
The Impact

Abstract Introduction Intraoperative radiotherapy (IORT) is more convenient than standard whole breast external beam radiotherapy (EBRT) as a sole adjuvant radiotherapy for breast cancer. The impact of age on breast cancer course and treatment strategy is still under investigation, and the peak age for breast cancer in Taiwan is much younger than that in Western countries. We aimed to review the oncological outcomes of sole IORT compared with standard EBRT in a country with younger breast cancer patients. Patients and methods We reviewed patients with invasive breast cancer who received breast-conserving surgery (BCS) from September 2014 to December 2016. The clinicopathologic characteristics and oncological outcomes of eligible patients who received EBRT or IORT as sole adjuvant radiotherapy after BCS were collected and reviewed. Results A total of 170 patients were enrolled with a mean follow-up time of 3.53 ± 0.82 years. The risk of locoregional recurrence was 2.44% for EBRT versus 10.64% for IORT (p = 0.024). IORT was a significant risk factor of locoregional recurrence (p = 0.005). The hazard ratios (HRs) for locoregional recurrence in the IORT group compared with the EBRT group were significantly higher in non-suitable risk group patients (HR = 7.02, p = 0.009) and in patients under 50 years old (HR = 10.42, p = 0.011). Conclusions Locoregional recurrence was significantly higher in patients who received IORT than in those who underwent EBRT. IORT should not be used alone in patients under 50 years old who do not belong to a suitable group.

Initiation of an Intraoperative Radiotherapy Program at a Safety net Hospital: What Is the Impact of an Intraoperative Radiotherapy Program in Underserved Patients With Early Breast Cancer?

2020 ◽  
pp. 000313482095635
Author(s):  
Priti Lalchandani ◽  
Chad Sila ◽  
Junko Ozao-Choy ◽  
Christine Dauphine
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Intraoperative Radiotherapy ◽  
Safety Net ◽  
Wound Complications ◽  
Axillary Lymph ◽  
Complication Rates ◽  
Eligibility Criteria ◽  
Safety Net Hospital ◽  
The Impact

Background Intraoperative radiotherapy (IORT) can allow for single-dose radiation treatment following breast conservation therapy in low-risk patients with early breast cancer, in lieu of a traditional 6-week course of whole breast radiotherapy (WBRT). The objective of this study was to analyze the uptake and utilization of an IORT program in a safety-net hospital. Materials and Methods A retrospective review was conducted for all patients who underwent IORT from September 2014 to June 2018. Patient demographics, tumor characteristics, and IORT outcomes were analyzed. The proportion of patients undergoing IORT were determined to assess utilization and uptake. Results There were 27 female patients that received IORT, 23 (85.2%) of which required no further radiotherapy. Three (7.4%) patients had positive axillary lymph nodes and/or positive margins requiring subsequent WBRT. One patient (3.7%) developed an in-breast recurrence distant from the lumpectomy site 23 months after IORT. Ten patients (37.0%) developed a postoperative complication, including 5 seromas and 6 wound complications (superficial infections and/or wound necrosis). Overall, in the 46-month study period, IORT accounted for only 6.4% of 423 operations. Still, 27 of 29 (93.1%) patients who met eligibility criteria for IORT underwent the procedure. Discussion Although IORT comprised only 6.4% of all cases due to higher rates of mastectomy rates and advanced disease in our population, there was a high uptake of IORT among patients who met eligibility criteria for the procedure. Major complication rates of IORT were low, and most patients successfully completed radiotherapy in 1 intraoperative dose.

Sole Adjuvant Intraoperative Breast Radiotherapy in Taiwan: A Single-Center Experience

2020 ◽  
Author(s):  
Hsin-Yi Yang ◽  
Chi-Wen Tu ◽  
Yu-Chen Hsu
Keyword(s):  
Breast Cancer ◽  
Adjuvant Radiotherapy ◽  
Locoregional Recurrence ◽  
External Beam Radiotherapy ◽  
Significant Risk ◽  
Intraoperative Radiotherapy ◽  
Breast Cancer Patients ◽  
Clinicopathologic Characteristics ◽  
Oncological Outcomes ◽  
The Impact

Abstract Introduction: Intraoperative radiotherapy (IORT) is more convenient than standard whole-breast external beam radiotherapy (EBRT) as a sole adjuvant radiotherapy for breast cancer. The impact of age on breast cancer course and treatment strategy is still under investigation, and the peak age for breast cancer in Taiwan is much younger than that in Western countries. We aimed to review the oncological outcomes of sole IORT compared with standard EBRT in a country with younger breast cancer patients.Patients and methods: We reviewed patients with invasive breast cancer who received breast-conserving surgery (BCS) from September 2014 to December 2016. The clinicopathologic characteristics and oncological outcomes of eligible patients who received EBRT or IORT as sole adjuvant radiotherapy after BCS were collected and reviewed.Results: A total of 170 patients were enrolled with a mean follow-up time of 3.53 ± 0.82 years. The risk of locoregional recurrence was 2.44% for EBRT versus 10.64% for IORT (p = 0.024). IORT was a significant risk factor of locoregional recurrence (p = 0.005). The hazard ratios (HRs) for locoregional recurrence in the IORT group compared with the EBRT group were significantly higher in non-suitable risk group patients (HR = 7.02, p = 0.009) and in patients under 50 years old (HR = 10.42, p = 0.011).Conclusions: Locoregional recurrence was significantly higher in patients who received IORT than in those who underwent EBRT. IORT should not be used alone in patients under 50 years old who do not belong to a suitable group.

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