Biologic comparison of partial breast irradiation protocols

Rosenstein, Barry S.; Lymberis, S.; Formenti, Silvia C.

doi:10.1016/j.ijrobp.2004.05.072

Cited by 91 publications

(53 citation statements)

References 73 publications

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“…Also, the radiation dose kills breast cancer cells. In the clinical planning, the volume of PTV_EVAL may consist of the mixture of many types of tissues for a particular patient, as reported by Rosenstein et al ( 21 ) In an ideal situation where each type of tissue can be exclusively identified in the breast and delineated on the planning CT images, tissue‐specific DVH can be generated for each volume of tissue type. However, with current MammoSite planning systems it is impossible to extract those tissue‐specific DVH data.…”

Section: Discussionmentioning

confidence: 99%

“…Those acute and late effects were clinically the most common and widely investigated in many toxicity and cosmesis outcome studies ( 14 – 21 ) following MammoSite treatments. The BED values for breast carcinoma were also calculated.…”

Section: Methodsmentioning

confidence: 99%

“…The α/β ratio was adopted from the literature for specific clinical endpoints. ( 21 – 25 ) For acute normal tissue effects, α/β values of 8 Gy and 11 Gy were used for erythema and desquamation, respectively. For late normal tissue effects, α/β values of 2 Gy and 4 Gy were used for fibrosis and telangiectasia, respectively.…”

Section: Methodsmentioning

confidence: 99%

“…An α/β value of 4 was used for breast carcinoma. ( 21 , 26 ) An α value of 0.3

{Gy}^{- 1}

and

{normalT}_{eff}

value of 13 days were used for the cell repopulation term. ( 14 , 27 ) …”

Section: Methodsmentioning

confidence: 99%

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Evaluation of the interfractional biological effective dose (BED) variation in MammoSite high dose rate brachytherapy

Kim

Werts

Trombetta

et al. 2010

J Applied Clin Med Phys

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The objective of this work is to evaluate the interfractional biological effective dose (BED) variation in MammoSite high dose rate (HDR) brachytherapy. Dose distributions of 19 patients who received 34 Gy in 10 fractions were evaluated. A method was employed to account for nonuniform dose distribution in the BED calculation. Furthermore, a range of α/β values was utilized for specific clinical end points: fibrosis, telangiectasia, erythema, desquamation and breast carcinoma. Two scenarios were simulated to calculate the BED value using: i) the same dose distribution of fraction 1 over fractions 2–10 (constant case, CC), and ii) the actual delivered dose distribution for each fraction 1–10 (interfraction dose variation case, IVC). Although the average BED difference (IVC – CC) was <0.7 Gy for all clinical endpoints, the range of difference for fibrosis and telangiectasia reached −11% to +3% and −9% to +9% for one of the patients, respectively. By disregarding high inhomogeneity in HDR brachytherapy, the conventional BED calculation tends to overestimate the BED for fibrosis by 16% on average, while it underestimates the BED for erythema (7.6%) and desquamation (10.2%). In conclusion, the BED calculation accounting for the nonuniform dose distribution provides a more clinically relevant description of the clinical delivered dose. Though the average BED difference was clinically insignificant, the maximum difference of BED for late effects can differ by a single fractional dose (10%) for a specific patient due to the interfraction dose variation in MammoSite treatment.PACS number: 87.53.Jw

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…An α/β value of 4 was used for breast carcinoma. ( 21 , 26 ) An α value of 0.3

{Gy}^{- 1}

and

{normalT}_{eff}

value of 13 days were used for the cell repopulation term. ( 14 , 27 ) …”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of the interfractional biological effective dose (BED) variation in MammoSite high dose rate brachytherapy

Kim

Werts

Trombetta

et al. 2010

J Applied Clin Med Phys

View full text Add to dashboard Cite

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“…Unfortunately, at this time, applicable pathological studies are scarce. Although -partial-breast‖ irradiation has been cited as the factor that permits -accelerated‖ irradiation, radiobiological calculation shows that the doses commonly delivered by APBI are actually equivalent to those of WBI in terms of both expected local control and toxicity [76] Therefore, the -partial‖ and -accelerated‖ aspects of APBI can be viewed as separate rather than going hand-in-hand. Accelerated WBI, commonly delivered over 3 weeks, is becoming more and more widely adopted.…”

Section: Apbi Vs Wbi:-mentioning

confidence: 99%

Accelerated Partial-Breast Irradiation: A State of the Art Strategy.

Hamoud¹,

Ghorbel²,

Falfali³

et al. 2017

IJAR

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Breast conservative surgery, partial breast irradiation, whole breast irradiation, , cosmetic results, Brachytherapy Breast-conserving therapy consists of wide local excision (WLE) followed by whole-breast irradiation (WBI).It is already widely accepted as an alternative to mastectomy. It is used for the treatment of patients with early-stage breast cancer. Accelerated partial-breast irradiation (APBI) is a new strategy. It is characterized by being shorter & an alternative radiation technique for a highly selected patients with favorable early-stage breast cancer. The objective of this review article is to analyze different modalities of APBI delivery and discuss the possible benefits and harms associated with this new platform. …………………………………………………………………………………………………….... Introduction:-Breast cancer has the highest incidence among all cancers in female. In early-stage breast cancer (stage ≤ II), the use of breast-conserving therapy (BCT) is a well-established treatment option. It is comparable to total mastectomy with good results as far as rates of local-regional control and overall survival. It enables patients to maintain their breasts with an acceptable cosmetic results [1]. In the initial trials regarding BCT that were done in the 1970s and 1980s, the new strategy typically involved segmental mastectomy with level I & II axillary lymph node dissection, followed by whole-breast irradiation (WBI). Radiation therapy (RT) is given with a dose of 45-50 Gy over the course of 5 weeks, with or without a boost to the tumor bed. WBI is a relatively well-tolerated treatment. This modality has resulted in good long-term cosmetic results, with low rates of treatment-associated morbidity. The Early Breast Cancer Trialists' Collaborative Group in their meta-analysis has demonstrated that the addition of radiation therapy (RT) to breast-conserving surgery has improved not only local-regional control, but also long-term overall survival [2]. In accelerated partial breast irradiation (APBI) a limited volume of breast tissue is irradiated. This includes tumor bed, lumpectomy or wide local excision with safety margins. It is delivered over a short period of time with increasing the fraction dose. Changing the strategy from whole breast irradiation to a small target (only part of the breast) as in APBI needs full investigation & scrutiny not only because of potential changes in local control but also for its possible impact on the overall survival . Aim of This Review:-Despite of the presence of advanced studies, the role, indication and the optimum APBI technique are still yet to be clearly identified. Therefore, in this review, we will try to find an answer for a number of controversial issues for better identification of the following:

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