Systematic and random set-up errors in patients having postoperative radiotherapy for breast cancer

2001 ◽  
Vol 37 ◽  
pp. S211
Author(s):  
M. Thomsom ◽  
M. Spalding ◽  
G. Dunn ◽  
P.A. Canney
Keyword(s):  
Breast Cancer ◽  
Postoperative Radiotherapy ◽  
Random Set ◽  
Set Up

scholarly journals Multiple screening approaches reveal HDAC6 as a novel regulator of glycolytic metabolism in triple-negative breast cancer

2021 ◽  
Vol 7 (3) ◽  
pp. eabc4897
Author(s):  
Catríona M. Dowling ◽  
Kate E. R. Hollinshead ◽  
Alessandra Di Grande ◽  
Justin Pritchard ◽  
Hua Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Histone Deacetylase Inhibitors ◽  
Triple Negative ◽  
Mitochondrial Apoptosis ◽  
Glycolytic Metabolism ◽  
Set Up ◽  
Screening Approaches

Triple-negative breast cancer (TNBC) is a subtype of breast cancer without a targeted form of therapy. Unfortunately, up to 70% of patients with TNBC develop resistance to treatment. A known contributor to chemoresistance is dysfunctional mitochondrial apoptosis signaling. We set up a phenotypic small-molecule screen to reveal vulnerabilities in TNBC cells that were independent of mitochondrial apoptosis. Using a functional genetic approach, we identified that a “hit” compound, BAS-2, had a potentially similar mechanism of action to histone deacetylase inhibitors (HDAC). An in vitro HDAC inhibitor assay confirmed that the compound selectively inhibited HDAC6. Using state-of-the-art acetylome mass spectrometry, we identified glycolytic substrates of HDAC6 in TNBC cells. We confirmed that inhibition or knockout of HDAC6 reduced glycolytic metabolism both in vitro and in vivo. Through a series of unbiased screening approaches, we have identified a previously unidentified role for HDAC6 in regulating glycolytic metabolism.

scholarly journals Use of Germline Genetic Variability for Prediction of Chemoresistance and Prognosis of Breast Cancer Patients

Cancers ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 511 ◽  
Author(s):  
Viktor Hlavac ◽  
Maria Kovacova ◽  
Katerina Elsnerova ◽  
Veronika Brynychova ◽  
Renata Kozevnikovova ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Disease Free Survival ◽  
Breast Cancer Patients ◽  
Cytotoxic Therapy ◽  
Free Survival ◽  
Testing Phase ◽  
Major Allele Frequency ◽  
Set Up ◽  
Disease Free

The aim of our study was to set up a panel for targeted sequencing of chemoresistance genes and the main transcription factors driving their expression and to evaluate their predictive and prognostic value in breast cancer patients. Coding and regulatory regions of 509 genes, selected from PharmGKB and Phenopedia, were sequenced using massive parallel sequencing in blood DNA from 105 breast cancer patients in the testing phase. In total, 18,245 variants were identified of which 2565 were novel variants (without rs number in dbSNP build 150) in the testing phase. Variants with major allele frequency over 0.05 were further prioritized for validation phase based on a newly developed decision tree. Using emerging in silico tools and pharmacogenomic databases for functional predictions and associations with response to cytotoxic therapy or disease-free survival of patients, 55 putative variants were identified and used for validation in 805 patients with clinical follow up using KASPTM technology. In conclusion, associations of rs2227291, rs2293194, and rs4376673 (located in ATP7A, KCNAB1, and DFFB genes, respectively) with response to neoadjuvant cytotoxic therapy and rs1801160 in DPYD with disease-free survival of patients treated with cytotoxic drugs were validated and should be further functionally characterized.

scholarly journals A CROSS-SECTIONAL STUDY ON THE PREVALANCE AND RISK FACTORS OF LYMPHOEDEMA IN CARCINOMA BREAST

2017 ◽  
Vol 10 (6) ◽  
pp. 240
Author(s):  
Vishnu Gopal ◽  
Abhinabha Acharya ◽  
Vasudha Narayanaswamy ◽  
Santanu Pal
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Breast Carcinoma ◽  
Upper Limb ◽  
Cancer Care ◽  
Postoperative Radiotherapy ◽  
Care Center ◽  
Locally Advanced ◽  
Significant Risk ◽  
Axillary Lymph

Objectives: Lymphedema of the arm is a devastating complication of breast carcinoma treatment. There is a lack of research on the risk factors and methods of preventing upper limb lymphedema after breast carcinoma treatment. The aims of the study are to identify the prevalence and risk factors for upper limb lymphedema in patients attending a tertiary cancer care center in India. Methods: 199 patients who attended the outpatient department of radiotherapy of IPGMER and SSKM, after undergoing surgical treatment for breast cancer between November 2014 to May 2016 were examined for the presence of lymphedema and its risk factors were analyzed. Lymphedema was defined as being present when there is an increase of >5% sum difference in the arm circumferences measured at different levels of both the upper limbs. Results: Of the 199 patients analyzed, 85 (42.7%) patients were found to have lymphedema. The prevalence of lymphedema was 25% in those who underwent surgery alone and 54% in those who underwent chest wall radiotherapy also. Locally advanced stage of the disease, body mass index >25 kg/m2, number of lymph nodes removed during surgery, and adjuvant radiotherapy were found to be significant risk factors for the development of lymphedema. Conclusion: Based on the results of this study, we recommend weight reduction and more judicious axillary lymph node dissection and use of postoperative radiotherapy as methods to prevent breast cancer-associated lymphedema in the tertiary cancer care centers in India.

scholarly journals An observational study of post-operative Volumetric Modulated Arc Radiotherapy (VMAT) of breast cancer by immobilizing patients on All-in-one (AIOTM) solution Breast and Lung Board without usingthermoplastic mask: Risk of collusion of gantry with couch exists if acquisition of Cone-beam Computed Tomography (CBCT)is attempted for set-up verification.

2020 ◽  
Author(s):  
Ramaiah Vinay Kumar
Keyword(s):  
Breast Cancer ◽  
Computed Tomography ◽  
Cancer Patients ◽  
Target Volume ◽  
Cone Beam ◽  
Breast Cancer Patients ◽  
Unilateral Breast Cancer ◽  
Planar Image ◽  
X Ray ◽  
Set Up

Abstract Background: Automatic Cone-beam computed tomography (CBCT) based image matching for set-up verification is recommended as compared to 2-D match for post-operative local / loco-regional radiotherapy of breast cancer patients by Volumetric Modulated Arc Therapy (VMAT) technique. However, in supine position, off-midline peripheral body Clinical Target Volume (CTV) of unilateral breast cancer patients immobilized on Breast and Lung board of All-in-One (AIO) positioning systemmay necessitate augmented movement of couch in ‘x’ and ‘z’ axis thereby raising the risk of collusion of x-ray sources / detectors system with couch. Methods and Materials: VMAT was planned by a pair of partial arc for whole target volume for seven consecutive post-operative breast cancer patients (five post-mastectomy and two post-breast conservation patients). Tattoo based set-up by shift of treatment table in x-, y- and z-axis as determined by Treatment Planning System followed by X-rays with planar image acquisition and online 2-D imaging matching was performed for set-up verification. In-room 360°rotation of x-ray source and detector system of linear accelerator (linac) was performed before x-ray planar image acquisition. Results: Completion of 360°rotation in-room of x-ray source and detector system of linacaround the machine iso-centre was not possible in six out of seven patients due to possibility of collusion of gantry with contralateral side of the couch. Conclusion: Performing CBCT for generating 3D images for computed tomography (CT) reconstruction may not be practical for patient set-up verification of post-operative radiotherapy of unilateral breast cancer patients positioned supine on breast and lung board.

scholarly journals Voluntary deep inspiration breath-hold reduces the heart dose without compromising the target volume coverage during radiotherapy for left-sided breast cancer

2018 ◽  
Vol 52 (1) ◽  
pp. 112-120 ◽  
Author(s):  
Noora Al-Hammadi ◽  
Palmira Caparrotti ◽  
Carole Naim ◽  
Jillian Hayes ◽  
Katherine Rebecca Benson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Postoperative Radiotherapy ◽  
Target Volume ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Random Errors ◽  
Breast Cancer Patients ◽  
Regional Lymph Nodes ◽  
Deep Inspiration Breath Hold ◽  
Cardiac Dose

Abstract Background During radiotherapy of left-sided breast cancer, parts of the heart are irradiated, which may lead to late toxicity. We report on the experience of single institution with cardiac-sparing radiotherapy using voluntary deep inspiration breath hold (V-DIBH) and compare its dosimetric outcome with free breathing (FB) technique. Patients and methods Left-sided breast cancer patients, treated at our department with postoperative radiotherapy of breast/chest wall +/– regional lymph nodes between May 2015 and January 2017, were considered for inclusion. FB-computed tomography (CT) was obtained and dose-planning performed. Cases with cardiac V25Gy ≥ 5% or risk factors for heart disease were coached for V-DIBH. Compliant patients were included. They underwent additional CT in V-DIBH for planning, followed by V-DIBH radiotherapy. Dose volume histogram parameters for heart, lung and optimized planning target volume (OPTV) were compared between FB and BH. Treatment setup shifts and systematic and random errors for V-DIBH technique were compared with FB historic control. Results Sixty-three patients were considered for V-DIBH. Nine (14.3%) were non-compliant at coaching, leaving 54 cases for analysis. When compared with FB, V-DIBH resulted in a significant reduction of mean cardiac dose from 6.1 +/– 2.5 to 3.2 +/– 1.4 Gy (p < 0.001), maximum cardiac dose from 51.1 +/– 1.4 to 48.5 +/– 6.8 Gy (p = 0.005) and cardiac V25Gy from 8.5 +/– 4.2 to 3.2 +/– 2.5% (p < 0.001). Heart volumes receiving low (10–20 Gy) and high (30–50 Gy) doses were also significantly reduced. Mean dose to the left anterior coronary artery was 23.0 (+/– 6.7) Gy and 14.8 (+/– 7.6) Gy on FB and V-DIBH, respectively (p < 0.001). Differences between FB- and V-DIBH-derived mean lung dose (11.3 +/– 3.2 vs. 10.6 +/– 2.6 Gy), lung V20Gy (20.5 +/– 7 vs. 19.5 +/– 5.1 Gy) and V95% for the OPTV (95.6 +/– 4.1 vs. 95.2 +/– 6.3%) were non-significant. V-DIBH-derived mean shifts for initial patient setup were ≤ 2.7 mm. Random and systematic errors were ≤ 2.1 mm. These results did not differ significantly from historic FB controls. Conclusions When compared with FB, V-DIBH demonstrated high setup accuracy and enabled significant reduction of cardiac doses without compromising the target volume coverage. Differences in lung doses were non-significant.

Lợi ích xạ trị ung thư vú trái phối hợp hít sâu nín thở và hệ thống quản lý bề mặt quang học của máy Truebeam tại Bệnh viện Ung bướu Thành phố Hồ Chí Minh

2021 ◽  
Author(s):  
Anh Phuong Le
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Management System ◽  
Left Breast ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Optical Surface ◽  
Deep Inspiration Breath Hold ◽  
Cardiac Dose ◽  
Set Up

TÓM TẮT Đối với ung thư vú (UTV) xạ trị là điều trị bổ túc cần thiết giúp giảm tái phát tại chỗ tại vùng, gia tăng sống còn. Tuy nhiên, xạ trị có tác dụng phụ lên tim mạch nhất là với UTV trái. Nhiều nghiên cứu đã chứng minh biến chứng và tử vong do tim mạch tăng tỉ lệ thuận với liều trung bình lên tim. Các kỹ thuật xạ trị mới trong xạ trị ung thư vú trái giúp tối ưu hóa liều vào thể tích xạ và bảo vệ tốt hơn cơ quan lành, càng đòi hỏi độ chính xác cao khi đặt bệnh. Các sai số do thiết bị hoặc đặt bệnh sẽ dẫn đến nguy cơ quá liều dung nạp hoặc thiếu liều và có nguy cơ tái phát. Vì vậy, xạ trị đòi hỏi sự chính xác cao trong suốt quá trình từ mô phỏng đến lập kế hoạch và tiến hành xạ trị. Xạ trị ung thư vú trái phối hợp hít sâu nín thở (DIBH - Deep Inspiration Breath - hold) và hệ thống quản lý bề mặt quang học (OSMS - Optical Surface Management System) làm cho tim di chuyển ra xa hơn khỏi vú, thành ngực trong quá trình xạ trị, giúp giảm liều tim một cách rõ rệt, vẫn đảm bảo được liều xạ lên thể tích đích. Ưu điểm của OSMS ngoài áp dụng cho đặt bệnh nhanh không cần xăm dấu trên da còn giám sát thời gian thực trong toàn bộ quá trình điều trị. Khi nhịp thở của bệnh nhân vượt quá một ngưỡng nhất định (0,3cm) chùm tia bức xạ sẽ bị tắt để ngăn ngừa độc tính. Do đó, hiểu và nắm rõ lợi ích quy trình đặt bệnh giúp đạt mục tiêu điều trị đồng thời giảm thời gian đặt bệnh để người bệnh có tâm lý thoải mái hơn, giảm áp lực về số lượng bệnh, nhất là đối với các trung tâm xạ trị lớn. ABSTRACT BENEFITS OF LEFT BREAST CANCER RADIATION COMBINATION OF DEEP INSPIRATION BREATH - HOLD AND OPTICAL SURFACE MANAGEMENT SYSTEM OF TRUEBEAM MACHINE AT CANCER HOSPITAL HO CHI MINH CITY Background: For breast cancer, radiation therapy is an essential adjuvant treatment to help reduce local recurrence and increase survival. However, radiation therapy has adverse effects on the cardiovascular systemespecially for left breast cancer. Several studies have demonstrated that cardiovascular morbidity and mortality increase in proportion to the mean cardiac dose. New radiotherapy techniques in radiation therapy for left breast cancer help optimize dose to radiation volume and better protect healthy organs, which requires high accuracy when patient set - up. Errors due to equipment or patient set - up will lead to the risk of overdosage or underdosage and risk of relapse. Therefore, radiation therapy requires high precision throughout the process from simulation to planning and conducting radiation therapy. Radiation therapy for left breast cancer combined with Deep Inspiration Breath - hold (DIBH) and Optical Surface Management System (OSMS)causes the heart to move further away from the breast and chest wall during radiation therapy, helping to reduce the cardiac dose significantly, still ensuring the radiation dose to the target volume. The advantage of OSMS is that in addition to being applied for fastpatient set - up, without tattooing on the skin, it also provides real - time monitoring during the entire treatment process. When the patient’s breathing rate exceeds a certain threshold (0,3cm) the radiation beam is turned off to prevent toxicity. Therefore, understanding and understanding the benefits of patient set - up helps to achieve treatment goals, while reducing patient set - up time for more comfort, reducing pressure on the number of patients, especially for patients large radiotherapy center. Keyword: Radiation therapy for left breast cancer, Deep Inspiration Breath - hold, Optical Surface Management System, cardiovascular risk.

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