Comparison between different boost dose delivery techniques to the tumor bed of right sided breast cancer patients.

Comparisons between three different techniques by which the boost dose was delivered to the tumor bed were carried out , aiming to present the best technique of treatment for right breast cancer patients.In this study, ten right sided breast cancer computed tomography (CT) scans were selected for ten early right breast cancer patients. We made three different treatment plans for each patient CT using three different irradiation techniques to deliver a prescribed boost dose of 10 Gy in 5 fractions to the boost PTV. In the first technique, two tangential photon beams were used, in the second technique we, two oblique photon beams were used and in the third technique, a single electron beam was used. The comparative analyses between the three techniques were performed by comparing the boost PTV- dose volume histograms (DVHs), the ipsilateral breast (right breast) DVHs, the ipsilateral lung (right lung) DVHs and the heart DVHs of the three techniques for each patient. Furthermore the dose that covering 100% , 95% of the volume (D100% , D95%) and the volume covered by 95% of the dose (V95%)ofÂ the boost PTV of all techniques, were calculated for each patient to investigate the dose coverage of the target.Results showed that there were variations of the dose received by tumor bed, right breast and OARs depending on the technique used and the target location and size. A decrease of D100% than 90% of the prescribed dose was observed with the 3rd technique for patients 8, 9 and 10, and was observed with the 2nd technique for patient 5. A reduction of right breast dose was observed when the 3rd technique was use in comparison with the 1st and the 2nd techniques for patients 1, 2, 3, 4, 6 and 8.Â Also reduction of right breast was observed when the 2nd technique used in comparison with 1st technique. An increase of lung dose was observed with the 3rd technique for patients 1, 2, 5 and 6, also was observed with 2nd technique in patient 3, 5 and 7. A decrease of lung dose was observed with the 1st technique for patients 2, 4, 5, 6, 7, 8 and 9An individualized treatment, several plans using different irradiation techniques should be developed for each patient individually to reach the best boost PTV dose coverage with minimal OARsâ€™ dose.Â

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Evaluation of adaptive radiotherapy (ART) by use of replanning the tumor bed boost with repeated computed tomography (CT) simulation after whole breast irradiation (WBI) for breast cancer patients having clinically evident seroma

Japanese Journal of Radiology ◽

10.1007/s11604-018-0735-2 ◽

2018 ◽

Vol 36 (6) ◽

pp. 401-406 ◽

Cited By ~ 3

Author(s):

Omer Sager ◽

Ferrat Dincoglan ◽

Bora Uysal ◽

Selcuk Demiral ◽

Hakan Gamsiz ◽

...

Keyword(s):

Breast Cancer ◽

Computed Tomography ◽

Cancer Patients ◽

Adaptive Radiotherapy ◽

Whole Breast Irradiation ◽

Breast Irradiation ◽

Breast Cancer Patients ◽

Tumor Bed ◽

Ct Simulation ◽

Tumor Bed Boost

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Dose Distribution in the Heart and Cardiac Chambers following 4-field Radiation Therapy of Breast Cancer: a Retrospective Study

Breast Cancer Basic and Clinical Research ◽

10.4137/bcbcr.s11118 ◽

2013 ◽

Vol 7 ◽

pp. BCBCR.S11118 ◽

Cited By ~ 2

Author(s):

Safora Johansen ◽

Kristin H. Tjessem ◽

Kristian Fosså ◽

Gerhard Bosse ◽

Turi Danielsen ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Normal Tissue Complication Probability ◽

Radiation Doses ◽

Breast Cancer Patients ◽

Heart Volume ◽

Volume Percentage ◽

Dose Volume Histograms ◽

Field Radiation ◽

Whole Heart

Purpose To evaluate cardiac doses in breast cancer patients with stage II/III treated with 4-field radiotherapy based on computed tomography (CT) dose planning. Methods and Materials Based on archived CT images, whole heart and cardiac chamber radiation doses were analyzed in 216 (111 left-sided and 105 right-sided) mastectomized or lumpectomized breast cancer patients treated at a single institution, the Norwegian Radium Hospital, between 2000–2002. Individual dose volume histograms for the whole heart and for the four cardiac chambers were obtained, and mean, median and maximum doses to these structures were calculated. The dose (Gy) delivered to the 5% of the volume of each cardiac structure (D5%), and the volume percentage of each structure receiving ≥ 25 Gy (V25Gy) were reported. Normal tissue complication probability (NTCP) calculations were used to estimate the risk for ischemic heart disease (IHD). Results Cohort-based medians of the whole heart mean dose (Dmean) for left- and right-sided tumors were 3.2 Gy and 1.3 Gy, respectively, with similar ventricular but lower atrial values. The atrial doses did not differ according to laterality of the breast tumor. In 13 patients with left-sided cancer, 5% of the heart volume was exposed to >25 Gy. The NTCP estimates were generelly low, with a maximum of 2.8%. Conclusions During adjuvant CT-based locoregional radiotherapy of women with breast cancer, the cardiac radiation doses are, at the group level, below recommended threshold values (D5% < 25 Gy), though individual patients with left-sided disease may exceed these limits.

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Comparison of Radiotherapy Treatment Plans for Left-sided Breast Cancer Patients based on Three- and Four-dimensional Computed Tomography Imaging

Clinical Oncology ◽

10.1016/j.clon.2011.04.004 ◽

2011 ◽

Vol 23 (9) ◽

pp. 601-607 ◽

Cited By ~ 13

Author(s):

C. Bedi ◽

T. Kron ◽

D. Willis ◽

P. Hubbard ◽

A. Milner ◽

...

Keyword(s):

Breast Cancer ◽

Computed Tomography ◽

Cancer Patients ◽

Breast Cancer Patients ◽

Computed Tomography Imaging ◽

Tomography Imaging ◽

Treatment Plans ◽

Radiotherapy Treatment

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Value of preoperative staging of breast cancer patients using computed tomography to detect asymptomatic lung and liver metastasis

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.1105 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 1105-1105

Author(s):

W. Han ◽

H. Kim ◽

J. Lee ◽

K. Lee ◽

H. Moon ◽

...

Keyword(s):

Breast Cancer ◽

Computed Tomography ◽

Liver Metastasis ◽

Cancer Patients ◽

Early Breast Cancer ◽

Lung Metastasis ◽

Stage Iii ◽

Breast Cancer Patients ◽

Metastatic Lesions ◽

Treatment Plans

1105 Background: Preoperative clinical staging in breast cancer patients is important to determine the most appropriate treatment plans and to predict prognosis for individual patients. Identifying unexpected distant metastases in newly diagnosed breast cancer patients frequently alters initial treatment plans. Routine imaging studies to detect lung or liver metastasis is not indicated in patients with early and operable breast cancer. A recent study showed that routine use of chest radiograph and liver ultrasound does not provide much diagnostic benefit in early breast cancer patients. Methods: We aimed to investigate the value of preoperative computed tomography to detect asymptomatic liver and lung metastasis in breast cancer patients. We performed preoperative CT for 667 breast cancer patients to detect lung and liver metastasis among 1,636 primary breast cancer patients who had been diagnosed and treated between January 2006 and December 2007 at Seoul National University Hospital. Results: CT showed abnormal findings (suspicious of metastasis or indeterminate nodules) in 78 patients (10.5%). Among these, abnormal finding in 13 patients (1.7%) turned out to be true metastatic lesions. There was no CT-detected lung or liver metastasis in patients with T1 tumor and 4 metastases in patients with T2 tumor. There was no CT-detected lung or liver metastasis in patients with negative axillary lymph node metastasis. When patients were classified according to the AJCC staging, CT-detected true metastatic lesions were only present in stage III patients (13 out of 173 patients, 7.5%). The true metastatic lesions in lung or liver were all small sized nodules, ranging from 0.3cm to 1.2cm in largest diameters. In seven patients, the CT-detected metastatic lesions were less than 1cm which is in contrast with the previous studies. Conclusions: Our results demonstrated the lack of usefulness in performing routine CT exams to detect asymptomatic liver and lung metastasis in early breast cancer patients. Staging CT might be useful in stage III patients, since 13 (7.5%) patients were upstaged to stage IV by the use of CT. No significant financial relationships to disclose.

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The radiation doses to the heart and the left anterior descending coronary artery for various modes of radiation treatment of the breast cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e12092 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e12092-e12092

Author(s):

Elizaveta Maslyukova ◽

Luiza Korytova ◽

Anna Bondarenko ◽

Razifa Zhabina ◽

Oleg Korytov ◽

...

Keyword(s):

Breast Cancer ◽

At Risk ◽

Cancer Patients ◽

Supine Position ◽

Radiation Treatment ◽

Organs At Risk ◽

Free Breathing ◽

Breast Cancer Patients ◽

Heart Volume ◽

Treatment Plans

e12092 Background: The comparison of the radiation load to the organs at risk for three modes of radiation treatment of the breast cancer patients. Methods: The research includes the dosimetric radiation treatment plans for the 20 breast cancer patients with the left-side localization. They all underwent a computed tomography (CT) scan in standard supine position in free-breathing (FB), supine position with Active Breathing Control (ABC) device in deep inspiratory breath hold, and prone position in free-breathing (PP). Three-dimensional treatment plans were made for all 3 CTs. The dose valuations for 3D-planning were carried out for three CT- series. For each mode of radiation, the doze-volume parameters of organs at risk were estimated. Results: For all cases the contoured heart volume varied from 477 см3 - 1056 см3, with medium volume 769 см3. The best marks such as V25heart, medium doses to the heart and LAD, were achieved with on ABC methods (V25heart 4,26%, Dmean heart 3,13Gy, DmeanLAD 13,8Gy) in comparison FB (V25heart 9,49%, Dmean heart 4,97Gy, DmeanLAD 19,55Gy) and PP (V25heart 12,8%, Dmean heart 9,06Gy, DmeanLAD 24,18 Gy) (V25heart P = 0.00153, Dmean heart: P =0,000; Dmean LAD: P = 0.00088), when both the breast and the axillary nodes were included in the volume. The advantage of the dosimetric indexes for FB and ABC did not change while axillary and supraclavicular nodes were added to the radiation volume ABC (V25heart 3,49%, Dmean heart 3,08Gy, DmeanLAD 13,88Gy) in comparison with FB methods (V25heart 7,91%, Dmean heart 4,99Gy, DmeanLAD 19,89Gy) (V25heart P = 0.00205, Dmean heart: P =0,004; Dmean LAD: P = 0.03). Conclusions: Radiation treatment in the position on the back with controlled delay of breath on inspiration height contributed to the statistically significant reduction of the heart volume exposed to more than 25 Gy (V25heart), mean dose to the heart and mean dose to LAD.

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