scholarly journals Accelerated Hypofractionated Radiotherapy With Simultaneous Integrated Boost With Volumetric Modulated Arc Technique in Patients With Breast Cancer: a Phase 2 Study.

2021 ◽  
Author(s):  
Budhi Singh Yadav ◽  
Shipra Gupta ◽  
Divya Dahiya ◽  
Ankita Gupta ◽  
Arun Oinam
Keyword(s):  
Breast Cancer ◽  
Organs At Risk ◽  
Disease Free Survival ◽  
Skin Toxicity ◽  
Simultaneous Integrated Boost ◽  
Hypofractionated Radiotherapy ◽  
Acute Skin Toxicity ◽  
Integrated Boost ◽  
Left And Right ◽  
Accelerated Hypofractionated Radiotherapy

Abstract PurposeTo assess feasibility of accelerated hypofractionated radiotherapy with simultaneous integrated boost (SIB) with volumetric modulated arc technique (VMAT) in patients with breast cancer.Methods Total 27 patients after breast conserving surgery (BCS) were included in this study. Patients were planned on 4-dimensional computerized tomogram (4D-CT) and contouring was done using RTOG guidelines. Dose delivered was 34 Gy/10#/2wk to the breast and 40 Gy/10#/2wk to the tumor bed as SIB with VMAT technique. The primary endpoint was grade 2 acute skin toxicity. Doses to the organs at risk were calculated. Toxicities and cosmesis were assessed using RTOG LENT-SOMA and HARVARD/NSABP/RTOG grading scales, respectively. Disease-free survival (DFS) and overall survival (OS) was calculated with Kaplan Meier curves.ResultsMean age of the patients was 42 years. Left and right breast cancer was seen in 17 (63%) and 10 (37%) patients, respectively. Ipsilateral lung mean V16 and contralateral lung V5 was 16.01% and 3.73%, respectively. Mean heart dose from the left and right breast was 7.25Gy and 4.37Gy, respectively. Mean dose to the contralateral breast, oesophagus and spinal cord was 2.64Gy, 3.69Gy and 3.15Gy, respectively. Thyroid V25 mean was 19.69%.Grade 1 and 2 acute skin toxicity was observed in 9 (33%) and 5 (18.5%) patients, respectively. Grade 2 hyperpigmentation, edema and induration were observed in 1 (3.7%), 2 (7.4%) and 4(14.8%) patients, respectively. Mild breast pain and arm/shoulder discomfort were reported by 1 (3.4%) patient each. Median follow-up was 48 months (range 12-58 months). At 4 years breast induration, edema and fibrosis each were observed in 1(3.7%) patient. Cosmesis was excellent and good in 21 (78%) and 6 (22%) patients, respectively. Local recurrence and distant metastases occurred 1(3.7%) and 2(7.4%) patients, respectively. DFS and OS at 3-years was 88% and 92%, respectively.ConclusionWith this RT schedule acute and late toxicity rates were acceptable with no adverse cosmesis. Local control, DFS and OS were good.

scholarly journals Hypofractionated radiotherapy in ten fractions for postmastectomy patients: a phase II study compared with another hypofractionation schedule with sixteen fractions

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Huayong Jiang ◽  
Lingling Meng ◽  
Huijuan Zhang ◽  
Xiangkun Dai ◽  
Qian Zhang ◽  
...  
Keyword(s):  
Phase Ii ◽  
Phase Ii Study ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Skin Toxicity ◽  
Trial Registration ◽  
Hypofractionated Radiotherapy ◽  
Free Survival ◽  
Acute Skin Toxicity

Abstract Background The purpose of this phase II study was to evaluate the feasibility of hypofractionated radiotherapy (HFRT) with a dose of 36.5 Gy in 10 fractions in postmastectomy patients. Methods From March 2014 to December 2015, 85 patients with locally advanced breast cancer were eligible to participate in this study with a schedule of 36.5 Gy in 10 fractions. Intensity-modulated radiation therapy (IMRT) was delivered to the chest wall with or without the supraclavicular region. The primary endpoint was radiation-related toxicities. The secondary endpoints were locoregional failure-free survival (LRFFS), disease-free survival (DFS) and overall survival (OS). And the outcomes were compared with our retrospective study of 72 patients with 42.5 Gy in 16 fractions. Results The median follow-up was 69.0 (range 66.5-71.5) months in the 36.5 Gy group and 93.0 (range 91.9-94.1) months in the 42.5 Gy group, respectively. Radiation-related toxicities were mainly grade 1, although a few patients had grade 2 plexopathy (1.2%) and acute skin toxicity (1.2%) in the 36.5 Gy group, and grade 2 acute skin toxicity (5.6%) and lymphedema (4.2%) in the 42.5 Gy group. There were no significant differences between the groups in acute and late toxicities. For all the patients, the 5-year LRFFS, DFS and OS were 97.7 and 100.0%, 93.1 and 90.3%, 98.8 and 97.2%, respectively, without significant differences between the groups. Conclusion Postmastectomy HFRT with a schedule of 36.5 Gy in 10 fractions was feasible, with mild toxicities and excellent 5-year clinical outcome. Trial registration Trial registration number: ChiCTR-ONRC-14004391. Date of registration: 9/3/2014.

scholarly journals Adjuvant hypofractionated radiotherapy with simultaneous integrated boost after breast-conserving surgery: results of a prospective trial

2020 ◽  
Author(s):  
David Krug ◽  
René Baumann ◽  
Katja Krockenberger ◽  
Reinhard Vonthein ◽  
Andreas Schreiber ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Radiotherapy ◽  
Prospective Trial ◽  
Treatment Protocol ◽  
Breast Conserving Surgery ◽  
Simultaneous Integrated Boost ◽  
Hypofractionated Radiotherapy ◽  
Tumor Bed ◽  
Integrated Boost ◽  
3D Crt

Abstract Purpose We report results of a multicenter prospective single-arm phase II trial (ARO-2013-04, NCT01948726) of moderately accelerated hypofractionated radiotherapy with a simultaneous integrated boost (SIB) in patients with breast cancer receiving adjuvant radiotherapy after breast-conserving surgery. Methods The eligibility criteria included unifocal breast cancer with an indication for adjuvant radiotherapy to the whole breast and boost radiotherapy to the tumor bed. The whole breast received a dose of 40 Gy and the tumor bed a total dose of 48 Gy in 16 fractions of 2.5 and 3 Gy, respectively. Radiotherapy could be given either as 3D conformal RT (3D-CRT) or as intensity-modulated radiotherapy (IMRT). The study was designed as a prospective single-arm trial to evaluate the acute toxicity of the treatment regimen. The study hypothesis was that the frequency of acute skin reaction grade ≥2 would be 20% or less. Results From November 2013 through July 2014, 149 patients were recruited from 12 participating centers. Six patients were excluded, leaving 143 patients for analysis. Eighty-four patients (58.7%) were treated with 3D-CRT and 59 (41.3%) with IMRT. Adherence to the treatment protocol was high. The rate of grade ≥2 skin toxicity was 14.7% (95% confidence interval 9.8–21.4%). The most frequent grade 3 toxicity (11%) was hot flashes. Conclusion This study demonstrated low toxicity of and high treatment adherence to hypofractionated adjuvant radiotherapy with SIB in a multicenter prospective trial, although the primary hypothesis was not met.

scholarly journals OC-0262: Simultaneous integrated boost in external radiotherapy for breast cancer. Skin toxicity

2015 ◽  
Vol 115 ◽  
pp. S134
Author(s):  
L. Ribes Llopis ◽  
J.L. Monroy Antón ◽  
E. Molina Luque ◽  
M. Soler Tortosa ◽  
M. Lopez Muñoz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Skin Toxicity ◽  
Simultaneous Integrated Boost ◽  
External Radiotherapy ◽  
Integrated Boost

scholarly journals Hypofractionated Radiotherapy for Post-Operative Breast Cancer Patients at Delta Hospital - an Evaluation of Clinical Experience

2015 ◽  
Vol 3 (1) ◽  
pp. 4-8 ◽  
Author(s):  
Parvin Akhter Banu ◽  
Naheed Rukhsana ◽  
MA Jabber ◽  
Motiur Rahman ◽  
Sadiq R Malik
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Ductal Carcinoma ◽  
Therapy Group ◽  
Breast Conservation ◽  
Skin Toxicity ◽  
Hypofractionated Radiotherapy ◽  
Breast Cancer Patients ◽  
Acute Skin Toxicity

Background: As hypofractionated radiotherapy for post-operative breast cancer patients safe, effective and more convenient, it might be beneficial for patients of developing countries like ours. Objective: This study was done to evaluate the safety and efficacy of hypofractionated whole breast radiation therapy in patients who underwent breast conserving surgery and hypofractionated radiation therapy in patients who underwent mastectomy and axillary clearance. Materials and method: This cross sectional study was conducted in Delta Hospital Ltd, Dhaka, Bangladesh, including 50 postoperative patients, (12 patients in Breast Conservation Therapy group and 38 in Post Mastectomy Radiation Therapy group), with invasive ductal carcinoma of breast treated with this hypofractionated radiotherapy protocol during the last 1.5 year. The patients were treated with 3DCRT, LINAC, 6 MV photon and appropriate electron energy. Results: Minimal post treatment acute morbidity was observed. Forty seven patients (94%) had grade-I acute skin toxicity and only 3 patients (6%) developed grade-II acute skin toxicity. Conclusion: Hypofractionated radiotherapy is as safe and effective as conventional fractionated radiotherapy and superior in terms of convenience. DOI: http://dx.doi.org/10.3329/dmcj.v3i1.22232 Delta Med Col J. Jan 2015; 3(1): 04-08

scholarly journals Simultaneous Integrated Boost in Once-weekly Hypofractionated Radiotherapy for Breast Cancer in the Elderly: Preliminary Evidence

In Vivo ◽  
2019 ◽  
Vol 33 (6) ◽  
pp. 1985-1992
Author(s):  
ELISABETTA BONZANO ◽  
LILIANA BELGIOIA ◽  
GIORGIA POLIZZI ◽  
GUIDO SIFFREDI ◽  
PIERO FREGATTI ◽  
...  
Keyword(s):  
Breast Cancer ◽  
The Elderly ◽  
Preliminary Evidence ◽  
Simultaneous Integrated Boost ◽  
Hypofractionated Radiotherapy ◽  
Integrated Boost

scholarly journals Dosimetric and Radiobiological Comparison of Five Techniques for Postmastectomy Radiotherapy with Simultaneous Integrated Boost

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Du Tang ◽  
Zhan Liang ◽  
Fada Guan ◽  
Zhen Yang
Keyword(s):  
Breast Cancer ◽  
Organs At Risk ◽  
Intensity Modulated Radiotherapy ◽  
Normal Tissue Complication Probability ◽  
Simultaneous Integrated Boost ◽  
Conformity Index ◽  
Postmastectomy Radiotherapy ◽  
Integrated Boost ◽  
Similar Good ◽  
Delivery Efficiency

Purpose. To compare five techniques for the postmastectomy radiotherapy (PMRT) with simultaneous integrated boost (SIB). Materials and Methods. Twenty patients with left-sided breast cancer were retrospectively selected. Five treatment plans were created for each patient: TomoDirect (TD), unblocked helical TomoTherapy (unb-HT), blocked HT (b-HT), hybrid intensity-modulated radiotherapy (hy-IMRT), and fixed-field IMRT (ff-IMRT). A dose of 50.4 Gy in 28 fractions to PTVtotal and 60.2 Gy in 28 fractions to PTVboost were prescribed. The dosimetric parameters for targets and organs at risk (OARs), the normal tissue complication probability (NTCP), the second cancer complication probability (SCCP) for OARs, and the treatment efficiency were assessed and compared. Results. TD plans and hy-IMRT plans had similar good dose coverage and homogeneity for both PTVboost and PTVtotal and superior dose sparing for the lungs and heart. The ff-IMRT plans had similar dosimetric results for the target volumes compared with the TD and hy-IMRT plans, but gave a relatively higher NTCP and SCCP for the lungs. The unb-HT plans exhibited the highest OAR mean dose, highest NTCP for the lungs (0.97±1.25‰) and heart (4.58±3.62%), and highest SCCP for the lungs (3.57±0.05%) and contralateral breast (2.75±0.29%) among all techniques. The b-HT plans significantly outperformed unb-HT plans with respect to the sparing of the lungs and heart. This technique also showed the best conformity index (0.73±0.08) for PTVboost and the optimal NTCP for the lungs (0.03±0.03‰) and heart (0.61±0.73%). Concerning the delivery efficiency, the hy-IMRT and ff-IMRT achieved much higher delivery efficiency compared with TomoTherapy plans. Conclusion. Of the five techniques studied, TD and hy-IMRT are considered the preferable options for PMRT with SIB for left-sided breast cancer treatment and can be routinely applied in clinical practice.

scholarly journals Emerging Role of Hypofractionated Radiotherapy with Simultaneous Integrated Boost in Modern Radiotherapy of Breast Cancer

Breast Care ◽  
2015 ◽  
Vol 10 (5) ◽  
pp. 320-324 ◽  
Author(s):  
Mirko Nitsche ◽  
Juergen Dunst ◽  
Ulrich M. Carl ◽  
Robert M. Hermann
Keyword(s):  
Breast Cancer ◽  
Primary Tumor ◽  
Simultaneous Integrated Boost ◽  
Hypofractionated Radiotherapy ◽  
Scientific Background ◽  
Integrated Boost ◽  
Tumor Region ◽  
Modern Radiotherapy

Hypofractionated radiotherapy for breast cancer is becoming increasingly important. The scientific background of this development as well as the introduction of the simultaneous integrated boost to the primary tumor region in this context are discussed here.

scholarly journals Hypofractionated Simultaneous Integrated Boost Radiotherapy Versus Conventional Fractionation Radiotherapy of Early Breast Cancer After Breast-Conserving Surgery: Clinical Observation and Analysis

2021 ◽  
Vol 20 ◽  
pp. 153303382110647
Author(s):  
Jinling Dong ◽  
Ya Yang ◽  
Dan Han ◽  
Qian Zhao ◽  
Chengxin Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Skin Toxicity ◽  
Breast Conserving Surgery ◽  
Simultaneous Integrated Boost ◽  
Conventional Fractionation ◽  
Tumor Bed ◽  
Integrated Boost ◽  
Radiation Pneumonia ◽  
Boost Radiotherapy

Purpose: The objective of this retrospective study is to evaluate the efficacy and safety of hypofractionated simultaneous integrated boost radiotherapy for early breast cancer patients undergoing breast-conserving surgery. Methods: A total of 185 women with early breast cancer undergoing breast-conserving surgery were retrospectively divided into hypofractionated simultaneous integrated boost group and conventional fractionation group. Hypofractionated simultaneous integrated boost included 104 patients and the dose of whole-breast radiation reached 42.56 Gy in 16 fractions and simultaneously tumor bed boost to 48 Gy in 16 fractions, which course of radiotherapy was 22 days. The 81 patients of the conventional fractionation group received whole breast radiation to 50 Gy in 25 fractions and followed by tumor bed boost to 10 Gy in 5 fractions, which course of radiotherapy was 40 days. Clinical information including patients’ characteristics, skin toxicity, myelosuppression, radiation pneumonia, and cosmetic effects was recorded to analyze the influence of age, chemotherapy, position, and breast volume on the results of radiotherapy. Results: Hypofractionated simultaneous integrated boost group had no case of recurrence after a median follow-up of 25.6 months (9-47 months)) as compared with 2 after a median follow-up of 33.4 months (25-45 months) in the conventional fractionation group. The 2 groups had similar results in skin toxicity, cosmetic outcomes, and radiation pneumonia. In terms of myelosuppression, grade 1, grade 2, and grade 3 of myelosuppression in the hypofractionated simultaneous integrated boost group accounted for 16.7%, 12.3%, and 3.5% as compared with 30.0%, 21.1%, and 12.3% of the conventional fractionation group, respectively ( P = .000). Conclusions: HF-SIB RT is a considerable option in patients after breast-conserving surgery with a lower degree of myelosuppression and shorter treatment time.

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