Comparison of two treatment strategies for irradiation of regional lymph nodes in patients with breast cancer: Lymph flow guided portals versus standard radiation fields
Identifieur interne : 002C30 ( Main/Exploration ); précédent : 002C29; suivant : 002C31Comparison of two treatment strategies for irradiation of regional lymph nodes in patients with breast cancer: Lymph flow guided portals versus standard radiation fields
Auteurs : Sergey Nikolaevich Novikov [Russie] ; Sergey Vasilevich Kanaev [Russie] ; Vladimir Fedorovich Semiglazov [Russie] ; Ludmila Alekseevna Jukova [Russie] ; Pavel Ivanovich Krzhivitckiy [Russie]Source :
- Reports of Practical Oncology and Radiotherapy [ 1507-1367 ] ; 2014.
Abstract
Radiotherapy being an essential part of breast cancer treatment, we evaluate various radiotherapy strategies in patients with breast cancer.
Lymph node (LN) scintigraphy was performed in 172 primary patients with BC. LN visualization started 30–360 min after intratumoral injection of 75–150 MBq of 99mTc-nanocolloids.
Our standard recommendation for postoperative radiotherapy in patients with LN invasion by BC were as follows: for patients with external localization of tumour – breast + axillary (Ax) + sub-supraclavicular (SSCL) regions; with internal localization – all above + internal mammary nodes (IM). Proposed strategy of lymph flow guided radiotherapy is based on the assumption that only regions that contain ‘hot’ LNs must be included in a treatment volume.
Among 110 patients with external localization of BC, Ax LNs were visualized in all cases and in 62 patients it was the only region with ‘hot’ LN. Twenty-three patients (20.9%) had drainage to Ax + SSCL, 12 (10.9%) – Ax + IM, 13 (11.8%) – Ax + SSCL + IM regions. After the visualization of lymph flow patterns, standard treatment volume was changed in 87/110 cases (79.1%): in 56.4%, reduced, in 22.7%, enlarged or changed.
In 62 patients with tumours in internal quadrants, we revealed the following patterns of lymph-flow: only to the Ax region in 23 (37.1%); Ax + IM, 13 (21%); Ax + SSCL, 15 (24.2%); Ax + IM + ISSCL, 11 (17.7%) cases. After lymph-flow visualization, the standard irradiation volume was reduced in 53/62 (85.5%) cases.
Visualization of an individual lymph flow pattern from BC can be used for the optimization of standard fields used for irradiation of regional LNs.
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DOI: 10.1016/j.rpor.2014.06.001
PubMed: 25535581
PubMed Central: 4268592
Affiliations:
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Petrov Institute Oncology, Leningradskaya, 68, Pesochny-2, 194291 St. Petersburg, Russia</nlm:aff><country xml:lang="fr">Russie</country><wicri:regionArea>Department of Radiation Oncology and Nuclear Medicine, N.N. Petrov Institute Oncology, Leningradskaya, 68, Pesochny-2, 194291 St. Petersburg</wicri:regionArea><wicri:noRegion>194291 St. Petersburg</wicri:noRegion></affiliation></author><author><name sortKey="Kanaev, Sergey Vasilevich" sort="Kanaev, Sergey Vasilevich" uniqKey="Kanaev S" first="Sergey Vasilevich" last="Kanaev">Sergey Vasilevich Kanaev</name><affiliation wicri:level="1"><nlm:aff id="aff0005">Department of Radiation Oncology and Nuclear Medicine, N.N. Petrov Institute Oncology, Leningradskaya, 68, Pesochny-2, 194291 St. Petersburg, Russia</nlm:aff><country xml:lang="fr">Russie</country><wicri:regionArea>Department of Radiation Oncology and Nuclear Medicine, N.N. Petrov Institute Oncology, Leningradskaya, 68, Pesochny-2, 194291 St. Petersburg</wicri:regionArea><wicri:noRegion>194291 St. Petersburg</wicri:noRegion></affiliation></author><author><name sortKey="Semiglazov, Vladimir Fedorovich" sort="Semiglazov, Vladimir Fedorovich" uniqKey="Semiglazov V" first="Vladimir Fedorovich" last="Semiglazov">Vladimir Fedorovich Semiglazov</name><affiliation wicri:level="1"><nlm:aff id="aff0010">Department of Surgery No. 1 (Breast Cancer), N.N. Petrov Institute Oncology, Leningradskaya, 68, Pesochny-2, 194291 St. Petersburg, Russia</nlm:aff><country xml:lang="fr">Russie</country><wicri:regionArea>Department of Surgery No. 1 (Breast Cancer), N.N. Petrov Institute Oncology, Leningradskaya, 68, Pesochny-2, 194291 St. Petersburg</wicri:regionArea><wicri:noRegion>194291 St. Petersburg</wicri:noRegion></affiliation></author><author><name sortKey="Jukova, Ludmila Alekseevna" sort="Jukova, Ludmila Alekseevna" uniqKey="Jukova L" first="Ludmila Alekseevna" last="Jukova">Ludmila Alekseevna Jukova</name><affiliation wicri:level="1"><nlm:aff id="aff0005">Department of Radiation Oncology and Nuclear Medicine, N.N. Petrov Institute Oncology, Leningradskaya, 68, Pesochny-2, 194291 St. Petersburg, Russia</nlm:aff><country xml:lang="fr">Russie</country><wicri:regionArea>Department of Radiation Oncology and Nuclear Medicine, N.N. Petrov Institute Oncology, Leningradskaya, 68, Pesochny-2, 194291 St. Petersburg</wicri:regionArea><wicri:noRegion>194291 St. Petersburg</wicri:noRegion></affiliation></author><author><name sortKey="Krzhivitckiy, Pavel Ivanovich" sort="Krzhivitckiy, Pavel Ivanovich" uniqKey="Krzhivitckiy P" first="Pavel Ivanovich" last="Krzhivitckiy">Pavel Ivanovich Krzhivitckiy</name><affiliation wicri:level="1"><nlm:aff id="aff0005">Department of Radiation Oncology and Nuclear Medicine, N.N. Petrov Institute Oncology, Leningradskaya, 68, Pesochny-2, 194291 St. Petersburg, Russia</nlm:aff><country xml:lang="fr">Russie</country><wicri:regionArea>Department of Radiation Oncology and Nuclear Medicine, N.N. Petrov Institute Oncology, Leningradskaya, 68, Pesochny-2, 194291 St. Petersburg</wicri:regionArea><wicri:noRegion>194291 St. Petersburg</wicri:noRegion></affiliation></author></analytic><series><title level="j">Reports of Practical Oncology and Radiotherapy</title><idno type="ISSN">1507-1367</idno><idno type="eISSN">2083-4640</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Aim and Background</title><p>Radiotherapy being an essential part of breast cancer treatment, we evaluate various radiotherapy strategies in patients with breast cancer.</p></sec><sec><title>Materials and methods</title><p>Lymph node (LN) scintigraphy was performed in 172 primary patients with BC. LN visualization started 30–360 min after intratumoral injection of 75–150 MBq of 99mTc-nanocolloids.</p><p>Our standard recommendation for postoperative radiotherapy in patients with LN invasion by BC were as follows: for patients with external localization of tumour – breast + axillary (Ax) + sub-supraclavicular (SSCL) regions; with internal localization – all above + internal mammary nodes (IM). Proposed strategy of lymph flow guided radiotherapy is based on the assumption that only regions that contain ‘hot’ LNs must be included in a treatment volume.</p></sec><sec><title>Results</title><p>Among 110 patients with external localization of BC, Ax LNs were visualized in all cases and in 62 patients it was the only region with ‘hot’ LN. Twenty-three patients (20.9%) had drainage to Ax + SSCL, 12 (10.9%) – Ax + IM, 13 (11.8%) – Ax + SSCL + IM regions. After the visualization of lymph flow patterns, standard treatment volume was changed in 87/110 cases (79.1%): in 56.4%, reduced, in 22.7%, enlarged or changed.</p><p>In 62 patients with tumours in internal quadrants, we revealed the following patterns of lymph-flow: only to the Ax region in 23 (37.1%); Ax + IM, 13 (21%); Ax + SSCL, 15 (24.2%); Ax + IM + ISSCL, 11 (17.7%) cases. After lymph-flow visualization, the standard irradiation volume was reduced in 53/62 (85.5%) cases.</p></sec><sec><title>Conclusion</title><p>Visualization of an individual lymph flow pattern from BC can be used for the optimization of standard fields used for irradiation of regional LNs.</p></sec></div></front></TEI><affiliations><list><country><li>Russie</li></country></list><tree><country name="Russie"><noRegion><name sortKey="Novikov, Sergey Nikolaevich" sort="Novikov, Sergey Nikolaevich" uniqKey="Novikov S" first="Sergey Nikolaevich" last="Novikov">Sergey Nikolaevich Novikov</name></noRegion><name sortKey="Jukova, Ludmila Alekseevna" sort="Jukova, Ludmila Alekseevna" uniqKey="Jukova L" first="Ludmila Alekseevna" last="Jukova">Ludmila Alekseevna Jukova</name><name sortKey="Kanaev, Sergey Vasilevich" sort="Kanaev, Sergey Vasilevich" uniqKey="Kanaev S" first="Sergey Vasilevich" last="Kanaev">Sergey Vasilevich Kanaev</name><name sortKey="Krzhivitckiy, Pavel Ivanovich" sort="Krzhivitckiy, Pavel Ivanovich" uniqKey="Krzhivitckiy P" first="Pavel Ivanovich" last="Krzhivitckiy">Pavel Ivanovich Krzhivitckiy</name><name sortKey="Semiglazov, Vladimir Fedorovich" sort="Semiglazov, Vladimir Fedorovich" uniqKey="Semiglazov V" first="Vladimir Fedorovich" last="Semiglazov">Vladimir Fedorovich Semiglazov</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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