From Linac to Tomotherapy: New Possibilities for Cure?

Storme, Guy; Verellen, Dirk; Soete, Guy; Linthout, Nadine; Steene, Jan Van de; Voordeckers, Maria; Vinh‐Hung, Vincent; Tournel, Koen; Berge, D. Van Den

doi:10.1007/978-1-4020-5133-3_23

Cited by 4 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Tomotherapy is a treatment system which provides intensity modulated and volumetric image guidance radiation therapy (IMRT-IGRT) [ 7 , 8 ]. The irradiation is delivered helicoidally providing highly conformal shaping of dose distribution.…”

Section: Introductionmentioning

confidence: 99%

Cardiopulmonary-related patient-reported outcomes in a randomized clinical trial of radiation therapy for breast cancer

et al. 2021

View full text Add to dashboard Cite

Background Long-term prospective patient-reported outcomes (PRO) after breast cancer adjuvant radiotherapy is scarce. TomoBreast compared conventional radiotherapy (CR) with tomotherapy (TT), on the hypothesis that TT might reduce lung-heart toxicity. Methods Among 123 women consenting to participate, 64 were randomized to CR, 59 to TT. CR delivered 50 Gy in 25 fractions/5 weeks to breast/chest wall and regional nodes if node-positive, with a sequential boost (16 Gy/8 fractions/1.6 weeks) after lumpectomy. TT delivered 42 Gy/15 fractions/3 weeks to breast/chest wall and regional nodes if node-positive, 51 Gy simultaneous-integrated-boost in patients with lumpectomy. PRO were assessed using the European Organization for Research and Treatment of Cancer questionnaire QLQ-C30. PRO scores were converted into a symptom-free scale, 100 indicating a fully symptom-free score, 0 indicating total loss of freedom from symptom. Changes of PRO over time were analyzed using the linear mixed-effect model. Survival analysis computed time to > 10% PRO-deterioration. A post-hoc cardiorespiratory outcome was defined as deterioration in any of dyspnea, fatigue, physical functioning, or pain. Results At 10.4 years median follow-up, patients returned on average 9 questionnaires/patient, providing a total of 1139 PRO records. Item completeness was 96.6%. Missingness did not differ between the randomization arms. The PRO at baseline were below the nominal 100% symptom-free score, notably the mean fatigue-free score was 64.8% vs. 69.6%, pain-free was 75.4% vs. 75.3%, and dyspnea-free was 84.8% vs. 88.5%, in the TT vs. CR arm, respectively, although the differences were not significant. By mixed-effect modeling on early ≤2 years assessment, all three scores deteriorated, significantly for fatigue, P ≤ 0.01, without effect of randomization arm. By modeling on late assessment beyond 2 years, TT versus CR was not significantly associated with changes of fatigue-free or pain-free scores but was associated with a significant 8.9% improvement of freedom from dyspnea, P = 0.035. By survival analysis of the time to PRO deterioration, TT improved 10-year survival free of cardiorespiratory deterioration from 66.9% with CR to 84.5% with TT, P = 0.029. Conclusion Modern radiation therapy can significantly improve long-term PRO. Trial registration Trial registration number ClinicalTrials.govNCT00459628, April 12, 2007 prospectively.

show abstract

Section: Introductionmentioning

confidence: 99%

Cardiopulmonary-related patient-reported outcomes in a randomized clinical trial of radiation therapy for breast cancer

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Portal images were acquired once at the first treatment session, and thereafter infrequently. Meanwhile, tomotherapy became available at the Universitair Ziekenhuis Brussel (UZ Brussel) in summer 2006 ( 4 ). Tomotherapy is an integrated intensity-modulated radiotherapy (IMRT) helical system that combines a rotational linear accelerator delivering beamlets and a translational couch technique with integrated megavolt computed tomography allowing volumetric image guidance radiotherapy (IGRT), with the facility of online daily 3-dimensional image matching and repositioning.…”

Section: Introductionmentioning

confidence: 99%

Lung-heart toxicity in a randomized clinical trial of hypofractionated image guided radiation therapy for breast cancer

Van Parijs,

Cecilia-Joseph,

Gorobets

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

BackgroundTomoBreast hypothesized that hypofractionated 15 fractions/3 weeks image-guided radiation therapy (H-IGRT) can reduce lung-heart toxicity, as compared with normofractionated 25-33 fractions/5-7 weeks conventional radiation therapy (CRT).MethodsIn a single center 123 women with stage I-II operated breast cancer were randomized to receive CRT (N=64) or H-IGRT (N=59). The primary endpoint used a composite four-items measure of the time to 10% alteration in any of patient-reported outcomes, physician clinical evaluation, echocardiography or lung function tests, analyzed by intention-to-treat.ResultsAt 12 years median follow-up, overall and disease-free survivals between randomized arms were comparable, while survival time free from alteration significantly improved with H-IGRT which showed a gain of restricted mean survival time of 1.46 years over CRT, P=0.041.DiscussionThe finding establishes TomoBreast as a proof-of-concept that hypofractionated image-guided radiation-therapy can improve the sparing of lung-heart function in breast cancer adjuvant therapy without loss in disease-free survival. Hypofractionation is advantageous, conditional on using an advanced radiation technique. Multicenter validation may be warranted.Trial registrationhttps://clinicaltrials.gov/ct2/show/NCT00459628. Registered 12 April 2007.

show abstract

Cancer Therapeutics: Mechanism of Action, Radiation Toxicity, and Drug Formulation

Singh,

Ansari

2023

Photoprotective Green Pharmacology: Challenges, Sources and Future Applications

View full text Add to dashboard Cite

From Linac to Tomotherapy: New Possibilities for Cure?

Cited by 4 publications

References 0 publications

Cardiopulmonary-related patient-reported outcomes in a randomized clinical trial of radiation therapy for breast cancer

Cardiopulmonary-related patient-reported outcomes in a randomized clinical trial of radiation therapy for breast cancer

Lung-heart toxicity in a randomized clinical trial of hypofractionated image guided radiation therapy for breast cancer

Cancer Therapeutics: Mechanism of Action, Radiation Toxicity, and Drug Formulation

Contact Info

Product

Resources

About