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Title: Partial breast radiotherapy with simple teletherapy techniques

Abstract

A prospective pilot study of partial breast irradiation (PBI) with conventional vs hypofractionated schedules was set out. The study aimed to determine efficacy, acute and late side effects, and the preference of photon vs electron irradiation based on individual features. Patients were enrolled according to internationally accepted guidelines on PBI. Conformal radiotherapy plans were generated with both photon and electron beams, and the preferred technique based on dose homogeneity and the radiation exposure of healthy tissues was applied. For electron dose verification, a special phantom was constructed. Patients were randomized for fractionation schedules of 25 × 2 vs 13 × 3 Gy. Skin and breast changes were registered at the time of and ≥1 year after the completion of radiotherapy. Dose homogeneity was better with photons. If the tumor bed was located in the inner quadrants, electron beam gave superior results regarding conformity and sparing of organ at risk (OAR). If the tumor was situated in the lateral quadrants, conformity was better with photons. A depth of the tumor bed ≥3.0 cm predicted the superiority of photon irradiation (odds ratio [OR] = 23.6, 95% CI: 5.2 to 107.5, p < 0.001) with >90% sensitivity and specificity. After a median follow-upmore » of 39 months, among 72 irradiated cases, 1 local relapse out of the tumor bed was detected. Acute radiodermatitis of grade I to II, hyperpigmentation, and telangiectasia developed ≥1 year after radiotherapy, exclusively after electron beam radiotherapy. The choice of electrons or photons for PBI should be based on tumor bed location; the used methods are efficient and feasible.« less

Authors:
; ; ; ; ; ;
Publication Date:
OSTI Identifier:
22577839
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Dosimetry; Journal Volume: 40; Journal Issue: 4; Other Information: Copyright (c) 2015 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
61 RADIATION PROTECTION AND DOSIMETRY; 62 RADIOLOGY AND NUCLEAR MEDICINE; ANIMAL TISSUES; ELECTRON BEAMS; FRACTIONATION; HAZARDS; IRRADIATION; MAMMARY GLANDS; NEOPLASMS; PATIENTS; PHANTOMS; PHOTON BEAMS; RADIATION DOSES; RADIODERMATITIS; RADIOTHERAPY; RECOMMENDATIONS; SENSITIVITY; SIDE EFFECTS; SKIN; SPECIFICITY; TOXICITY; VERIFICATION

Citation Formats

Fekete, Gábor, Újhidy, Dóra, Együd, Zsófia, Kiscsatári, Laura, Marosi, Gusztáv, Kahán, Zsuzsanna, and Varga, Zoltán, E-mail: varga.zoltan@med.u-szeged.hu. Partial breast radiotherapy with simple teletherapy techniques. United States: N. p., 2015. Web. doi:10.1016/J.MEDDOS.2015.03.006.
Fekete, Gábor, Újhidy, Dóra, Együd, Zsófia, Kiscsatári, Laura, Marosi, Gusztáv, Kahán, Zsuzsanna, & Varga, Zoltán, E-mail: varga.zoltan@med.u-szeged.hu. Partial breast radiotherapy with simple teletherapy techniques. United States. doi:10.1016/J.MEDDOS.2015.03.006.
Fekete, Gábor, Újhidy, Dóra, Együd, Zsófia, Kiscsatári, Laura, Marosi, Gusztáv, Kahán, Zsuzsanna, and Varga, Zoltán, E-mail: varga.zoltan@med.u-szeged.hu. Thu . "Partial breast radiotherapy with simple teletherapy techniques". United States. doi:10.1016/J.MEDDOS.2015.03.006.
@article{osti_22577839,
title = {Partial breast radiotherapy with simple teletherapy techniques},
author = {Fekete, Gábor and Újhidy, Dóra and Együd, Zsófia and Kiscsatári, Laura and Marosi, Gusztáv and Kahán, Zsuzsanna and Varga, Zoltán, E-mail: varga.zoltan@med.u-szeged.hu},
abstractNote = {A prospective pilot study of partial breast irradiation (PBI) with conventional vs hypofractionated schedules was set out. The study aimed to determine efficacy, acute and late side effects, and the preference of photon vs electron irradiation based on individual features. Patients were enrolled according to internationally accepted guidelines on PBI. Conformal radiotherapy plans were generated with both photon and electron beams, and the preferred technique based on dose homogeneity and the radiation exposure of healthy tissues was applied. For electron dose verification, a special phantom was constructed. Patients were randomized for fractionation schedules of 25 × 2 vs 13 × 3 Gy. Skin and breast changes were registered at the time of and ≥1 year after the completion of radiotherapy. Dose homogeneity was better with photons. If the tumor bed was located in the inner quadrants, electron beam gave superior results regarding conformity and sparing of organ at risk (OAR). If the tumor was situated in the lateral quadrants, conformity was better with photons. A depth of the tumor bed ≥3.0 cm predicted the superiority of photon irradiation (odds ratio [OR] = 23.6, 95% CI: 5.2 to 107.5, p < 0.001) with >90% sensitivity and specificity. After a median follow-up of 39 months, among 72 irradiated cases, 1 local relapse out of the tumor bed was detected. Acute radiodermatitis of grade I to II, hyperpigmentation, and telangiectasia developed ≥1 year after radiotherapy, exclusively after electron beam radiotherapy. The choice of electrons or photons for PBI should be based on tumor bed location; the used methods are efficient and feasible.},
doi = {10.1016/J.MEDDOS.2015.03.006},
journal = {Medical Dosimetry},
number = 4,
volume = 40,
place = {United States},
year = {Thu Jan 01 00:00:00 EST 2015},
month = {Thu Jan 01 00:00:00 EST 2015}
}