Treatment constraints for single dose external beam preoperative partial breast irradiation in early-stage breast cancer
Background: Following breast-conserving surgery and post-operative 3D-conformal accelerated partial breast irradiation (APBI), suboptimal cosmetic results have been reported. Preoperative radiation delivery to the intact tumor enables better target visualization and treatment volume reduction. Singl...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2017-10-01
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| Series: | Clinical and Translational Radiation Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630817300265 |
| _version_ | 1818907168996327424 |
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| author | Ramona K. Charaghvandi Sua Yoo Bram van Asselen Anna Rodrigues Desirée H.J.G. van den Bongard Janet K. Horton |
| author_facet | Ramona K. Charaghvandi Sua Yoo Bram van Asselen Anna Rodrigues Desirée H.J.G. van den Bongard Janet K. Horton |
| author_sort | Ramona K. Charaghvandi |
| collection | DOAJ |
| description | Background: Following breast-conserving surgery and post-operative 3D-conformal accelerated partial breast irradiation (APBI), suboptimal cosmetic results have been reported. Preoperative radiation delivery to the intact tumor enables better target visualization and treatment volume reduction. Single dose preoperative APBI has the potential to improve toxicity profiles, reduce treatment burden and enable in vivo exploration of breast cancer radiogenomics.
Purpose: Develop practical guidelines for single dose external beam preoperative APBI.
Methods: Recommended dose constraints were derived from pooled dosimetry estimates from 2 clinical trials. In an American dose escalation trial, a uniform 15, 18 or 21 Gy dose has previously been evaluated for non-lobular cT1N0 or low/intermediate grade DCIS <2 cm in prone position (n = 32). In the Netherlands, the feasibility of ablative APBI (20 Gy to GTV, 15 Gy to CTV) to non-lobular cT1N0 in supine position, is currently being explored (n = 15). The dosimetric adherence to the developed constraints was evaluated in new APBI plans with a 21 Gy uniform dose but an extended CTV margin (n = 32).
Results: Dosimetric data pooling enabled the development of practical guidelines for single dose preoperative APBI.
Conclusion: The developed guidelines will allow further explorations in the promising field of single dose preoperative external beam APBI for breast cancer treatment. |
| first_indexed | 2024-12-19T21:50:50Z |
| format | Article |
| id | doaj.art-2288c061b7aa4ee89fa0677867739f81 |
| institution | Directory Open Access Journal |
| issn | 2405-6308 |
| language | English |
| last_indexed | 2024-12-19T21:50:50Z |
| publishDate | 2017-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj.art-2288c061b7aa4ee89fa0677867739f812022-12-21T20:04:25ZengElsevierClinical and Translational Radiation Oncology2405-63082017-10-016C71410.1016/j.ctro.2017.06.003Treatment constraints for single dose external beam preoperative partial breast irradiation in early-stage breast cancerRamona K. Charaghvandi0Sua Yoo1Bram van Asselen2Anna Rodrigues3Desirée H.J.G. van den Bongard4Janet K. Horton5Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The NetherlandsDepartment of Radiation Oncology, Duke Cancer Center, Durham, USADepartment of Radiation Oncology, University Medical Center Utrecht, Utrecht, The NetherlandsDepartment of Radiation Oncology, Duke Cancer Center, Durham, USADepartment of Radiation Oncology, University Medical Center Utrecht, Utrecht, The NetherlandsDepartment of Radiation Oncology, Duke Cancer Center, Durham, USABackground: Following breast-conserving surgery and post-operative 3D-conformal accelerated partial breast irradiation (APBI), suboptimal cosmetic results have been reported. Preoperative radiation delivery to the intact tumor enables better target visualization and treatment volume reduction. Single dose preoperative APBI has the potential to improve toxicity profiles, reduce treatment burden and enable in vivo exploration of breast cancer radiogenomics. Purpose: Develop practical guidelines for single dose external beam preoperative APBI. Methods: Recommended dose constraints were derived from pooled dosimetry estimates from 2 clinical trials. In an American dose escalation trial, a uniform 15, 18 or 21 Gy dose has previously been evaluated for non-lobular cT1N0 or low/intermediate grade DCIS <2 cm in prone position (n = 32). In the Netherlands, the feasibility of ablative APBI (20 Gy to GTV, 15 Gy to CTV) to non-lobular cT1N0 in supine position, is currently being explored (n = 15). The dosimetric adherence to the developed constraints was evaluated in new APBI plans with a 21 Gy uniform dose but an extended CTV margin (n = 32). Results: Dosimetric data pooling enabled the development of practical guidelines for single dose preoperative APBI. Conclusion: The developed guidelines will allow further explorations in the promising field of single dose preoperative external beam APBI for breast cancer treatment.http://www.sciencedirect.com/science/article/pii/S2405630817300265Single doseBreast cancerPartial breastPreoperativeGuidelines |
| spellingShingle | Ramona K. Charaghvandi Sua Yoo Bram van Asselen Anna Rodrigues Desirée H.J.G. van den Bongard Janet K. Horton Treatment constraints for single dose external beam preoperative partial breast irradiation in early-stage breast cancer Clinical and Translational Radiation Oncology Single dose Breast cancer Partial breast Preoperative Guidelines |
| title | Treatment constraints for single dose external beam preoperative partial breast irradiation in early-stage breast cancer |
| title_full | Treatment constraints for single dose external beam preoperative partial breast irradiation in early-stage breast cancer |
| title_fullStr | Treatment constraints for single dose external beam preoperative partial breast irradiation in early-stage breast cancer |
| title_full_unstemmed | Treatment constraints for single dose external beam preoperative partial breast irradiation in early-stage breast cancer |
| title_short | Treatment constraints for single dose external beam preoperative partial breast irradiation in early-stage breast cancer |
| title_sort | treatment constraints for single dose external beam preoperative partial breast irradiation in early stage breast cancer |
| topic | Single dose Breast cancer Partial breast Preoperative Guidelines |
| url | http://www.sciencedirect.com/science/article/pii/S2405630817300265 |
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