In Reply to Leung

Moraes, Fábio Ynoe de; Marta, Gustavo Nader; Hanna, Samir Abdallah; Leite, Elton Trigo Teixiera; Ferrigno, Robson; Silva, João Luís Fernandes da; Carvalho, Heloísa de Andrade

doi:10.1016/j.ijrobp.2015.07.2204

Cited by 3 publications

(4 citation statements)

References 2 publications

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“…It is known that specialized centers are needed to apply this effective technique and such tools are not available in most Brazilian RT services [38,39]. However, overcoming barriers to reducing mortality from BC in Brazil still involves access to screening mammography and, above all, the structuring of the care network for a quick and timely diagnostic investigation and access to quality treatment.…”

Section: Discussionmentioning

confidence: 99%

Deep inspiration breath hold: dosimetric benefits to decrease cardiac dose during postoperative radiation therapy for breast cancer patients

Degrande,

Marta,

Alves

et al. 2023

Rep Pract Oncol Radiother.

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Background: Postoperative radiation therapy (RT) is the standard treatment for almost all patients diagnosed with breast cancer. Even with modern RT techniques, parts of the heart may still receive higher doses than those recommended by clinically validated dose limit restrictions, especially when the left breast is irradiated. Deep inspiration breath hold (DIBH) may reduce irradiated cardiac volume compared to free breathing (FB) treatment. This study aimed to evaluate the dosimetric impact on the heart and left anterior descending coronary artery (LAD) in FB and DIBH RT planning in patients with left breast cancer. Materials and methods:A retrospective cohort study of women diagnosed with left-sided breast cancer submitted to breast surgery followed by postoperative RT from 2015 to 2019. All patients were planned with FB and DIBH and hypofractionated dose prescription (40.05 Gy in 15 fractions).Results: 68 patients were included in the study. For the coverage of the planned target volume evaluation [planning target volume (PTV) eval] there was no significant difference between the DIBH versus FB planning. For the heart and LAD parameters, all constraints evaluated favored DIBH planning, with statistical significance. Regarding the heart, median V16.8 Gy was 2.56% in FB vs. 0% in DIBH (p < 0.001); median V8.8 Gy was 3.47% in FB vs. 0% in DIBH (p < 0.001) and the median of mean heart dose was 1.97 Gy in FB vs. 0.92 Gy in DIBH (p < 0.001). For the LAD constraints D2% < 42 Gy, the median dose was 34.87 Gy in FB versus 5.8 Gy in DIBH (p < 0.001); V16.8 Gy < 10%, the median was 15.87% in FB versus 0% in DIBH (p < 0.001) and the median of mean LAD dose was 8.13Gy in FB versus 2.92Gy in DIBH (p < 0.001). Conclusions:The DIBH technique has consistently demonstrated a significant dose reduction in the heart and LAD in all evaluated constraints, while keeping the same dose coverage in the PTV eval.

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Section: Discussionmentioning

confidence: 99%

Deep inspiration breath hold: dosimetric benefits to decrease cardiac dose during postoperative radiation therapy for breast cancer patients

Degrande,

Marta,

Alves

et al. 2023

Rep Pract Oncol Radiother.

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“…But according to the Ministry of Health, there are currently only 269 radiotherapy devices that serve social security patients and they are often not exclusively dedicated to public care. 1 Again, the number falls far short of the needs.…”

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confidence: 99%

“…The main problems that contribute to this dicey scenario are related to inadequate remuneration and poor installed capacity, both from the point of view of the number of devices and their geographical distribution. 1 It is estimated that around 60% of all cancer patients will require radiotherapy at some stage of their treatment. 2 Thus, based on the rounded calculation of 600,000 patients diagnosed with cancer in Brazil in 2015, 3 360,000 should have received radiotherapy in that year.…”

mentioning

confidence: 99%

“…In the South and Southeast regions, installed capacity exceeds 60% of the demand, while in the North, Northeast and Midwest, it is less than 40%. 1 In 2011, the Federal Audit Court 5 audited a report on care for cancer patients in Brazil. In this report, the lack of radiotherapy was evident and the precarious situation of a large number of patients treated by the SUS, who waited on average 113.4 days between the date of diagnosis and the beginning of radiotherapy, became clear.…”

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confidence: 99%

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Radiotherapy and the SUS: A collapse foretold

Weltman

Marta

2017

Rev. Assoc. Med. Bras.

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Lung Cancer in Brazil

Mathias

Prado

Mascarenhas

et al. 2020

Journal of Thoracic Oncology

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Lung cancer is one of the most common incident cancers and a leading cause of cancer mortality in Brazil. Here, we aim to describe some aspects related to its prevention, diagnosis, and treatment in our country. Lung Cancer EpidemiologyIn Brazil, lung cancer is the second most common cancer in men and the fourth most common cancer in women, with 18,740 and 12,530 new cases, respectively, estimated for 2018 (Fig. 1). It is the leading cause of death due to cancer in men and the second such leading cause in women. 1 These numbers are largely underestimated, though, on account of a high rate of underdiagnosis and underreporting. The incidence of adenocarcinoma has been progressively increasing in comparison with that of squamous cell carcinoma in Brazil; in fact, it has become the predominant histologic type. In addition, the prevalence of NSCLC has been decreasing among men, whereas it has increased in the female population, mainly among never-smokers.

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In Reply to Leung

Cited by 3 publications

References 2 publications

Deep inspiration breath hold: dosimetric benefits to decrease cardiac dose during postoperative radiation therapy for breast cancer patients

Deep inspiration breath hold: dosimetric benefits to decrease cardiac dose during postoperative radiation therapy for breast cancer patients

Radiotherapy and the SUS: A collapse foretold

Lung Cancer in Brazil

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