TH-C-WAB-06: Target Volume Delineation Study of Compressed Sensing Cone-Beam CT for Head-And-Neck and Breast Cancer Patients During Radiation Therapy

2013 ◽  
Vol 40 (6Part32) ◽  
pp. 537-537 ◽  
Author(s):  
H Zhang ◽  
W Tan ◽  
J Sonke
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Compressed Sensing ◽  
Cancer Patients ◽  
Cone Beam Ct ◽  
Target Volume ◽  
Cone Beam ◽  
Breast Cancer Patients ◽  
Target Volume Delineation ◽  
Volume Delineation

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 Patterns of supraclavicular area failure after mastectomy in breast cancer patients: implications for target volume delineation

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052095331
Author(s):  
Pei-cheng Lin ◽  
Xi-jin Lin ◽  
Jin-luan Li ◽  
Fei-fei Lin ◽  
Qing-yang Zhuang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumor Size ◽  
Target Volume ◽  
Breast Cancer Patients ◽  
Target Volume Delineation ◽  
Volume Delineation ◽  
Supraclavicular Lymph Nodes ◽  
Level I ◽  
Metastatic Involvement ◽  
Medial Supraclavicular

Purpose To characterize the pattern of post-mastectomy supraclavicular lymph node (LN) metastases in patients with breast cancer (BC) and to provide insights for individualized clinical target volume delineation for radiotherapy. Methods We retrospectively analyzed 88 patients with BC who developed post-mastectomy regional LN metastases. The affected regional LNs were categorized as the ipsilateral medial supraclavicular LN area (IMSC-LN), ipsilateral lateral supraclavicular LN area (ILSC-LN), ipsilateral infraclavicular LN area (IIC-LN), and ≥2 groups in the ipsilateral clavicular LN area (MMIC-LN). Clinical characteristics were included in a multivariate analysis to identify risk factors for clavicular LN metastases. Results The ILSC-LNs (68.2%) were the most common metastatic site. IMSC-LN metastases showed a significant association with estrogen-receptor (ER) negative status, left-sided BC, and positive axillary LNs. Tumor size ≥2.4 cm and Her2 type were predictors of ILSC-LN metastases. Additionally, tumor size ≥2.4 cm, and level I ipsilateral axillary metastases were associated with MMIC-LN metastasis. Conclusion ILSC-LN was the most frequently affected group of supraclavicular lymph nodes. ER-negative status, left-sided BC, tumor size, and positive ipsilateral axillary LNs are potentially associated with the pattern of supraclavicular LN metastatic involvement.

scholarly journals An Update on Regional Nodal Irradiation: Indication, Target Volume Delineation, and Radiotherapy Techniques

Breast Care ◽  
2020 ◽  
Vol 15 (2) ◽  
pp. 128-135
Author(s):  
Marciana Nona Duma
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Metastatic Lymph Node ◽  
Target Volume ◽  
Breath Hold ◽  
Breast Cancer Patients ◽  
Target Volume Delineation ◽  
Regional Nodal Irradiation ◽  
Volume Delineation ◽  
Radiotherapy Techniques

Background: Tremendous changes have occurred in the treatment of breast cancer. This paper reviews and unifies the available data on modern axillary management of breast cancer patients with focus on the target volume delineation for regional nodal irradiation according to the most important contouring guidelines, the European Society for Radiotherapy and Oncology (ESTRO) and the Radiation Therapy and Oncology Group (RTOG). Summary: The use of extensive radiotherapy target volumes (level I, II, III, IV) is probably not necessary for all patients to reproduce the clinical benefit shown in the available randomized trials (EORTC, MA.20, AMAROS, Z0011). Nevertheless, given the results in the MA.20 trial, where the patients received more modern systemic therapies and high irradiation doses in the medial paraclavicular region (level IV) and level II, it can be justified to include these regions completely in selected high-risk patients. Key Messages: High-tangent irradiation results in a similar dose distribution in axillary levels I and II compared to the AMAROS treatment field design in some patients. This supports earlier assumptions that irradiation may have accounted for the good results after sentinel lymph node dissection alone in the Z0011 trial. The ESTRO and RTOG clinical target volume (CTV) definitions cover sufficiently the metastatic lymph node hotspots, with a better coverage for the ESTRO CTV. Further, contouring according to the ESTRO would spare a significantly larger part of the healthy lymphatic system, making it our preferred contouring atlas. Modern radiotherapy techniques, such as deep inspiration breath hold, should be cautiously employed in patients treated according to the inclusion criteria of the Z0011 as it will result in a lower dose to the axillary levels.

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