The long-term outcome of adjuvant hypofractionated radiotherapy and conventional fractionated radiotherapy after breast-conserving surgery for early breast cancer: a prospective analysis of 107 cases

Zhao, Suping; Liu, Yi; Huang, Fengxian; Chen, Xin; Cao, Ximing; Yu, Jiao

doi:10.21037/jtd.2017.09.125

Cited by 10 publications

(5 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Again, in breast cancer, various dosing regimens of RT are available. So far, recent clinical studies have agreed that hypofractionation (>2 Gy as single dose per fraction) leads to comparable long-term efficacy and even reduced delayed toxic effects compared to normofractionated RT schemes [27][28][29][30].…”

Section: Augmenting Breast Cancer Cell Death By Microwave-based Hyperthermia and Radiotherapymentioning

confidence: 99%

Differences of the Immune Phenotype of Breast Cancer Cells after Ex Vivo Hyperthermia by Warm-Water or Microwave Radiation in a Closed-Loop System Alone or in Combination with Radiotherapy

Häder

Savcigil

Rosin

et al. 2020

Cancers

View full text Add to dashboard Cite

The treatment of breast cancer by radiotherapy can be complemented by hyperthermia. Little is known about how the immune phenotype of tumor cells is changed thereby, also in terms of a dependence on the heating method. We developed a sterile closed-loop system, using either a warm-water bath or a microwave at 2.45 GHz to examine the impact of ex vivo hyperthermia on cell death, the release of HSP70, and the expression of immune checkpoint molecules (ICMs) on MCF-7 and MDA-MB-231 breast cancer cells by multicolor flow cytometry and ELISA. Heating was performed between 39 and 44 °C. Numerical process simulations identified temperature distributions. Additionally, irradiation with 2 × 5 Gy or 5 × 2 Gy was applied. We observed a release of HSP70 after hyperthermia at all examined temperatures and independently of the heating method, but microwave heating was more effective in cell killing, and microwave heating with and without radiotherapy increased subsequent HSP70 concentrations. Adding hyperthermia to radiotherapy, dynamically or individually, affected the expression of the ICM PD-L1, PD-L2, HVEM, ICOS-L, CD137-L, OX40-L, CD27-L, and EGFR on breast cancer cells. Well-characterized pre-clinical heating systems are mandatory to screen the immune phenotype of tumor cells in clinically relevant settings to define immune matrices for therapy adaption.

show abstract

Section: Augmenting Breast Cancer Cell Death By Microwave-based Hyperthermia and Radiotherapymentioning

confidence: 99%

Differences of the Immune Phenotype of Breast Cancer Cells after Ex Vivo Hyperthermia by Warm-Water or Microwave Radiation in a Closed-Loop System Alone or in Combination with Radiotherapy

Häder

Savcigil

Rosin

et al. 2020

Cancers

View full text Add to dashboard Cite

show abstract

“…In MD Anderson 21 and a Chinese 22 study, all patients had a boost after the whole-breast hypofractionated RT. No increased toxicity was observed with the addition of a boost to the hypofractionated models when compared to conventional therapy 16,20, 22 .…”

Section: % Strongmentioning

confidence: 99%

Recommendations for hypofractionated whole-breast irradiation

Freitas¹,

Rosa²,

Marta

et al. 2018

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

This recommendation consensus for hypofractionated whole-breast radiotherapy (RT) was organized by the Brazilian Society of Radiotherapy (SBRT) considering the optimal scenario for indication and safety in the technology applied. All controversies and contraindication matters (hypofractionated RT in patients who underwent chemotherapy [CT], hypofractionated RT in lymphatic drainage, hypofractionated RT after mastectomy with or without immediate reconstruction, boost during surgery, hypofractionated RT in patients under 50 years old, hypofractionated RT in large breasts, hypofractionated RT in histology of carcinoma in situ [DCIS]) was discussed during a meeting in person, and a consensus was reached when there was an agreement of at least 75% among panel members. The grade for recommendation was also suggested according to the level of scientific evidence available, qualified as weak, medium, or strong. Thus, this consensus will aid Brazilian radiotherapy experts regarding indications and particularities of this technique as a viable and safe alternative for the national reality.

show abstract

“…11 Long follow-up of these trials as well as meta-analyses have not demonstrated the hypothesized increase in late toxicity with hypofractionated regimens. [12][13][14] Together, these data support hypofractionation in the management of many diseases. Hypofractionation has only been made possible by improvements in tumor localization through advances in image-guided radiation therapy (IGRT).…”

mentioning

confidence: 69%

Three discipline collaborative radiation therapy (3DCRT) special debate: We should treat all cancer patients with hypofractionation

Green

Nest

Soisson

et al. 2020

J Applied Clin Med Phys

View full text Add to dashboard Cite

Radiation Oncology is a highly multidisciplinary medical specialty, drawing significantly from three scientific disciplinesmedicine, physics, and biology. As a result, discussion of controversies or changes in practice within radiation oncology must involve input from all three disciplines. For this reason, significant effort has been expended recently to foster collaborative multidisciplinary research in radiation oncology, with substantial demonstrated benefit. 1-3 In light of these results, we endeavor here to adopt this "team-science" approach to the traditional debates featured in this journal. This article is part of a series of special debates entitled "Three Discipline Collaborative Radiation Therapy (3DCRT)" in which each debate team will include a radiation oncologist, medical physicist, and radiobiologist. We hope that this format will not only be engaging for the readership but will also foster further collaboration in the science and clinical practice of radiation oncology. 2 | INTRODUCTION Better Physics, just within this 21st century, now enables us to deliver radiation to a target volume with accuracy better than 1 mm. Given this accuracy, why fractionate at all? If we can put dose only on the cancer, and extremely little on critical normal tissue, then surely just give a high single dose to that cancer, and job done. Local tumor control is 100% with minimal toxicity. If only. Two linked issues keep Biology (radiobiology) in the clinical game. First, our ability to identify, localize, and immobilize anatomy and pathology does not yet correspond with this submillimeter accuracy of radiotherapy delivery. Second, even if that imaging resolution is reached it could still not detect occult disease. Consequently, unless the cancer is truly isolated, which it sometimes may be, for example, in organ-confined early-stage prostate cancer, it is always necessary to "degrade" the treatment plan by defining a CTV and PTV into which the radiation delivery is expanded. This inevitably imposes a risk of normaltissue radiotoxicity, therefore we must use fractionation to minimize that risk. Traditionally, that fractionation has been carried out with doses close to 2 Gy per fraction. In fractionation, the Linear-Quadratic (LQ) model describes the relationship between total dose and dose per fraction, for isoeffect. A lower α/β value indicates a steeper relationship. Generally late-reacting normal tissues exhibit lower α/β and early-reacting normal tissues exhibit higher α/β. Malignancies can have lower or higher α/β depending on the tumor type. In some malignancies, notably human prostate, clinical data indeed indicate α/ β as low as 1.5 and thus in prostate cancers, and likewise in earlystage breast cancers, hypofractionation, arbitrarily defined as a dose per fraction> 2.2 Gy, has become standard of care. In early-stage non-small cell lung cancers a higher α/β is seen, similar to early-reacting normal tissue, but these isolated malignancies can still be more effectively controlled with radical hypofractionation wh...

show abstract

The long-term outcome of adjuvant hypofractionated radiotherapy and conventional fractionated radiotherapy after breast-conserving surgery for early breast cancer: a prospective analysis of 107 cases

Cited by 10 publications

References 28 publications

Differences of the Immune Phenotype of Breast Cancer Cells after Ex Vivo Hyperthermia by Warm-Water or Microwave Radiation in a Closed-Loop System Alone or in Combination with Radiotherapy

Differences of the Immune Phenotype of Breast Cancer Cells after Ex Vivo Hyperthermia by Warm-Water or Microwave Radiation in a Closed-Loop System Alone or in Combination with Radiotherapy

Recommendations for hypofractionated whole-breast irradiation

Three discipline collaborative radiation therapy (3DCRT) special debate: We should treat all cancer patients with hypofractionation

Contact Info

Product

Resources

About