Local Control of Breast Cancer with Tumorectomy Plus Radiotherapy or Radiotherapy Alone

Ghossein, Nemetallah Ā.; Stacey, Patricia; Alpert, Seymour; Ager, Phyllis J.; Krishnaswamy, V.

doi:10.1148/121.2.455

Cited by 32 publications

(4 citation statements)

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“…These findings were subsequently confirmed by other authors [11,13,15,18]. The vast majority of new disease manifestations were documented in areas distant from the irradiation fields and this led to the conclusion that most women with locally advanced breast cancer have indeed distant micrometastases at the time of diagnosis.…”

Section: Introductionsupporting

confidence: 69%

T3b-T4 breast cancer: factors affecting results in combined modality treatments

et al. 1983

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Two hundred and seventy-seven consecutive patients with T3b-T4 breast cancer referred to the Milan Cancer Institute between 1973 and 1980 were treated with a combined modality approach. Chemotherapy (CT) consisted of AV, i.e. adriamycin (60-75 mg/m2 day 1) and vincristine (1.2 mg/m2 days 1 and 8) and was given for three to four cycles prior to local regional modality. Local-regional treatment consisted of either radiotherapy (RT) in 198 patients or surgery (S) in 79 women. Additional chemotherapy was then administered to a total of 205 patients. In the absence of distant metastases, frequency of good local control was significantly inferior in patients given CT + RT (63.9 per cent) compared to those treated with CT + RT + CT (75.4 per cent) and CT + S + CT (82.3 per cent, P = 0.033). Also freedom from progression (FFP) and overall survival (SURV) were significantly superior in the groups receiving more prolonged chemotherapy treatment compared to patients treated with CT + RT (FFP: P less than 0.0001; SURV: P = 0.002). None of the variables examined was able to affect the response rate, while axillary nodal status and tumor size played a major role in the duration of FFP and SURV. Our findings indicate that a more aggressive treatment is needed to improve current results in this stage of disease. To overcome the problem of local-regional recurrence, treatment should probably begin with cytoreductive surgery followed by postoperative radiotherapy in all patients with the exception of those having inflammatory carcinoma. Systemic treatment should then be delivered to control distant micrometastases.

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Section: Introductionsupporting

confidence: 69%

T3b-T4 breast cancer: factors affecting results in combined modality treatments

et al. 1983

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“…However, clinical follow‐up of our breast cancer patients showed a 10‐year relapse‐free survival rate of 96.9% (31) . The difference with the TCP found by Ghossein et al (29) (i.e., 93.4%) can be ascribed to the boost of 16 Gy, which is included in our clinical follow‐up. Poortmans et al (32) reported that the boost decreases the 10‐year local recurrence rate with 4%.…”

Section: Discussioncontrasting

confidence: 50%

“…In contrast, there is little knowledge on the reference dose distribution for TCP calculation, as the clinical follow-up study was performed before 1976. (29) In the 1960s and '70s, 3D treatment planning was very rare, and the first publications on the type-a (30) and the type-b (3) dose-calculation algorithms date from 1992 and 1989, respectively. During the clinical followup study, only the prescribed dose was known.…”

Section: E Aim 2: Determination Of Algorithm-specific Tcp and Ntcp Fmentioning

confidence: 99%

The photon dose calculation algorithm used in breast radiotherapy has significant impact on the parameters of radiobiological models

Petillion

Swinnen

Defraene

et al. 2014

J Applied Clin Med Phys

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The comparison of the pencil beam dose calculation algorithm with modified Batho heterogeneity correction (PBC‐MB) and the analytical anisotropic algorithm (AAA) and the mutual comparison of advanced dose calculation algorithms used in breast radiotherapy have focused on the differences between the physical dose distributions. Studies on the radiobiological impact of the algorithm (both on the tumor control and the moderate breast fibrosis prediction) are lacking. We, therefore, investigated the radiobiological impact of the dose calculation algorithm in whole breast radiotherapy. The clinical dose distributions of 30 breast cancer patients, calculated with PBC‐MB, were recalculated with fixed monitor units using more advanced algorithms: AAA and Acuros XB. For the latter, both dose reporting modes were used (i.e., dose‐to‐medium and dose‐to‐water). Next, the tumor control probability (TCP) and the normal tissue complication probability (NTCP) of each dose distribution were calculated with the Poisson model and with the relative seriality model, respectively. The endpoint for the NTCP calculation was moderate breast fibrosis five years post treatment. The differences were checked for significance with the paired t‐test. The more advanced algorithms predicted a significantly lower TCP and NTCP of moderate breast fibrosis then found during the corresponding clinical follow‐up study based on PBC calculations. The differences varied between 1% and 2.1% for the TCP and between 2.9% and 5.5% for the NTCP of moderate breast fibrosis. The significant differences were eliminated by determination of algorithm‐specific model parameters using least square fitting. Application of the new parameters on a second group of 30 breast cancer patients proved their appropriateness. In this study, we assessed the impact of the dose calculation algorithms used in whole breast radiotherapy on the parameters of the radiobiological models. The radiobiological impact was eliminated by determination of algorithm specific model parameters.PACS numbers: 87.55.dh, 87.55.dk

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“…The reports came from the experience of single institutions such as the Harvard Joint Center, Yale University, Albert Einstein College of Medicine, the M. D. Anderson Cancer Center, and Princess Margaret Hospital in Toronto. [1][2][3][4][5] Six centers in France reported similar results at the American Radium Society Meeting in 1976. 6 This historic body of literature did not represent the first time breast conservation surgery had been used.…”

mentioning

confidence: 74%

Partial-Breast Radiation for Early Staged Breast Cancers: Hypothesis, Existing Data, and a Planned Phase III Trial

McCormick

2005

J Natl Compr Canc Netw

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This review of clinical data from partial-breast treatment studies discusses results from a single institution's experience using brachytherapy catheters, the MammoSite balloon (Proxima Company, Alpharetta, GA), and three-dimensional external beam partial-breast treatment. Rationale, techniques, dose schedules, and available results are presented. Intra-operative single-dose radiation to the lumpectomy site is also reviewed. The National Surgical Adjuvant Breast and Bowel Project (NSABP) and Radiation Therapy Oncology Group (RTOG) cooperative groups are opening a phase III trial to compare partial-breast treatment to the standard 5- to 6-week course of whole-breast radiation. The design of this study is also presented in this review.

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Local Control of Breast Cancer with Tumorectomy Plus Radiotherapy or Radiotherapy Alone

Cited by 32 publications

References 0 publications

T3b-T4 breast cancer: factors affecting results in combined modality treatments

T3b-T4 breast cancer: factors affecting results in combined modality treatments

The photon dose calculation algorithm used in breast radiotherapy has significant impact on the parameters of radiobiological models

Partial-Breast Radiation for Early Staged Breast Cancers: Hypothesis, Existing Data, and a Planned Phase III Trial

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