LymphedemaV1, Pmc, Checkpoint, bibRecord, 000259

Helical TomoTherapy for locally advanced or recurrent breast cancer

Identifieur interne : 000259 ( Pmc/Checkpoint ); précédent : 000258; suivant : 000260

Helical TomoTherapy for locally advanced or recurrent breast cancer

Auteurs : M. N. Duma [Allemagne] ; C. Heinrich [Allemagne] ; C. Schönknecht [Allemagne] ; B. Chizzali [Allemagne] ; M. Mayinger [Allemagne] ; M. Devecka [Allemagne] ; S. Kampfer [Allemagne] ; S. E. Combs [Allemagne]

Source :

Radiation Oncology (London, England) [ 1748-717X ] ; 2017.

RBID : PMC:5273793

Abstract

Purpose

We report our experience of using helical tomotherapy (HT) to treat large and irregular shaped loco-regional advanced breast cancer target volumes embracing various organs at risk.

Patients and methods

We retrospectively analyzed 26 patients treated for very large, irregular shaped breast cancers. Patients were treated either with the intent to achieve local control in a primary setting (n = 14) or in a reirradiation setting (n = 12). The recurrence group was heavily pretreated with systemic therapy. Tumors were characterized by wide infiltration of the skin, encompassing mostly a complete hemithorax. The primary group underwent irradiation of supraclavicular, infraclavicular, axillary and parasternal lymphonodal region. Radiotherapy was combined with chemotherapy (n = 11). We assessed the PTV volume and its craniocaudal extension, the dose to the organs at risk, acute toxicity and survival.

Results

Median PTV was 2276 cm³ (1476–6837 cm³) with a median cranio-caudal extension of 28 cm (15–52 cm). The median dose to PTV was 40 Gy (32–60Gy). HT could be carried out in all patients without interruption. The acute toxicities were mild to moderate. The median LRFS and OS after radiotherapy was 21 and 57 months for the primary group versus 10 and 11 months for the recurrence group. Median PFS was 18 months (primary group) and 7 months (recurrence group).

Conclusions

HT is feasible for advanced thorax embracing target volumes with acceptable acute toxicity. Both curative and palliative indications can be considered good indications based on treatment volume and anatomical constellation.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5273793

DOI: 10.1186/s13014-016-0736-1
PubMed: 28129767
PubMed Central: 5273793

Affiliations:

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Ismaninger Str. 22, 81675 München, Germany</nlm:aff>
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<author><name sortKey="Chizzali, B" sort="Chizzali, B" uniqKey="Chizzali B" first="B." last="Chizzali">B. Chizzali</name>
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<author><name sortKey="Mayinger, M" sort="Mayinger, M" uniqKey="Mayinger M" first="M." last="Mayinger">M. Mayinger</name>
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Ismaninger Str. 22, 81675 München, Germany</nlm:aff>
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<placeName><region type="land" nuts="1">Bavière</region>
<region type="district" nuts="2">District de Haute-Bavière</region>
<settlement type="city">Munich</settlement>
</placeName>
</affiliation>
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<author><name sortKey="Devecka, M" sort="Devecka, M" uniqKey="Devecka M" first="M." last="Devecka">M. Devecka</name>
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Ismaninger Str. 22, 81675 München, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Ismaninger Str. 22, 81675 München</wicri:regionArea>
<placeName><region type="land" nuts="1">Bavière</region>
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<settlement type="city">Munich</settlement>
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<author><name sortKey="Kampfer, S" sort="Kampfer, S" uniqKey="Kampfer S" first="S." last="Kampfer">S. Kampfer</name>
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Ismaninger Str. 22, 81675 München, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
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<placeName><region type="land" nuts="1">Bavière</region>
<region type="district" nuts="2">District de Haute-Bavière</region>
<settlement type="city">Munich</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Combs, S E" sort="Combs, S E" uniqKey="Combs S" first="S. E." last="Combs">S. E. Combs</name>
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Ismaninger Str. 22, 81675 München, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Ismaninger Str. 22, 81675 München</wicri:regionArea>
<placeName><region type="land" nuts="1">Bavière</region>
<region type="district" nuts="2">District de Haute-Bavière</region>
<settlement type="city">Munich</settlement>
</placeName>
</affiliation>
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<institution>Institute of Innovative Radiotherapy (iRT),</institution>
<institution>Helmholtz Zentrum München,</institution>
</institution-wrap>
München, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>München</wicri:regionArea>
</affiliation>
</author>
</analytic>
<series><title level="j">Radiation Oncology (London, England)</title>
<idno type="eISSN">1748-717X</idno>
<imprint><date when="2017">2017</date>
</imprint>
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<front><div type="abstract" xml:lang="en"><sec><title>Purpose</title>
<p>We report our experience of using helical tomotherapy (HT) to treat large and irregular shaped loco-regional advanced breast cancer target volumes embracing various organs at risk.</p>
</sec>
<sec><title>Patients and methods</title>
<p>We retrospectively analyzed 26 patients treated for very large, irregular shaped breast cancers. Patients were treated either with the intent to achieve local control in a primary setting (<italic>n</italic>
 = 14) or in a reirradiation setting (<italic>n</italic>
 = 12). The recurrence group was heavily pretreated with systemic therapy. Tumors were characterized by wide infiltration of the skin, encompassing mostly a complete hemithorax. The primary group underwent irradiation of supraclavicular, infraclavicular, axillary and parasternal lymphonodal region. Radiotherapy was combined with chemotherapy (<italic>n</italic>
 = 11). We assessed the PTV volume and its craniocaudal extension, the dose to the organs at risk, acute toxicity and survival.</p>
</sec>
<sec><title>Results</title>
<p>Median PTV was 2276 cm<sup>3</sup>
 (1476–6837 cm<sup>3</sup>
) with a median cranio-caudal extension of 28 cm (15–52 cm). The median dose to PTV was 40 Gy (32–60Gy). HT could be carried out in all patients without interruption. The acute toxicities were mild to moderate. The median LRFS and OS after radiotherapy was 21 and 57 months for the primary group versus 10 and 11 months for the recurrence group. Median PFS was 18 months (primary group) and 7 months (recurrence group).</p>
</sec>
<sec><title>Conclusions</title>
<p>HT is feasible for advanced thorax embracing target volumes with acceptable acute toxicity. Both curative and palliative indications can be considered good indications based on treatment volume and anatomical constellation.</p>
</sec>
</div>
</front>
<back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Jobsen, Jj" uniqKey="Jobsen J">JJ Jobsen</name>
</author>
<author><name sortKey="Van Der Palen, J" uniqKey="Van Der Palen J">J van der Palen</name>
</author>
<author><name sortKey="Meerwaldt, Jh" uniqKey="Meerwaldt J">JH Meerwaldt</name>
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</TEI>
<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
  <front><journal-meta><journal-id journal-id-type="nlm-ta">Radiat Oncol</journal-id>
<journal-id journal-id-type="iso-abbrev">Radiat Oncol</journal-id>
<journal-title-group><journal-title>Radiation Oncology (London, England)</journal-title>
</journal-title-group>
<issn pub-type="epub">1748-717X</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
<publisher-loc>London</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">28129767</article-id>
<article-id pub-id-type="pmc">5273793</article-id>
<article-id pub-id-type="publisher-id">736</article-id>
<article-id pub-id-type="doi">10.1186/s13014-016-0736-1</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research</subject>
</subj-group>
</article-categories>
<title-group><article-title>Helical TomoTherapy for locally advanced or recurrent breast cancer</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Duma</surname>
<given-names>M. N.</given-names>
</name>
<address><phone>0049 89 4140 5063</phone>
<email>Marciana.Duma@mri.tum.de</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Heinrich</surname>
<given-names>C.</given-names>
</name>
<address><email>heinrich_cs@t-online.de</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Schönknecht</surname>
<given-names>C.</given-names>
</name>
<address><email>christine.schoenknecht@mri.tum.de</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Chizzali</surname>
<given-names>B.</given-names>
</name>
<address><email>barbara.chizzali@mri.tum.de</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mayinger</surname>
<given-names>M.</given-names>
</name>
<address><email>michael.mayinger@mri.tum.de</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Devecka</surname>
<given-names>M.</given-names>
</name>
<address><email>michal.devecka@mri.tum.de</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kampfer</surname>
<given-names>S.</given-names>
</name>
<address><email>severin.kampfer@mri.tum.de</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Combs</surname>
<given-names>S. E.</given-names>
</name>
<address><email>Stephanie.Combs@tum.de</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff3">3</xref>
</contrib>
<aff id="Aff1"><label>1</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0477 2438</institution-id>
<institution-id institution-id-type="GRID">grid.15474.33</institution-id>
<institution>Department of Radiation Oncology,</institution>
<institution>Klinikum rechts der Isar der Technischen Universität München,</institution>
</institution-wrap>
Ismaninger Str. 22, 81675 München, Germany</aff>
<aff id="Aff2"><label>2</label>
Praxis für Strahlentherapie, Hausham, Germany</aff>
<aff id="Aff3"><label>3</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0483 2525</institution-id>
<institution-id institution-id-type="GRID">grid.4567.0</institution-id>
<institution>Institute of Innovative Radiotherapy (iRT),</institution>
<institution>Helmholtz Zentrum München,</institution>
</institution-wrap>
München, Germany</aff>
</contrib-group>
<pub-date pub-type="epub"><day>28</day>
<month>1</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>28</day>
<month>1</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="collection"><year>2017</year>
</pub-date>
<volume>12</volume>
<elocation-id>31</elocation-id>
<history><date date-type="received"><day>19</day>
<month>2</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>1</day>
<month>12</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>© The Author(s). 2016</copyright-statement>
<license license-type="OpenAccess"><license-p><bold>Open Access</bold>
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>
) applies to the data made available in this article, unless otherwise stated.</license-p>
</license>
</permissions>
<abstract id="Abs1"><sec><title>Purpose</title>
<p>We report our experience of using helical tomotherapy (HT) to treat large and irregular shaped loco-regional advanced breast cancer target volumes embracing various organs at risk.</p>
</sec>
<sec><title>Patients and methods</title>
<p>We retrospectively analyzed 26 patients treated for very large, irregular shaped breast cancers. Patients were treated either with the intent to achieve local control in a primary setting (<italic>n</italic>
 = 14) or in a reirradiation setting (<italic>n</italic>
 = 12). The recurrence group was heavily pretreated with systemic therapy. Tumors were characterized by wide infiltration of the skin, encompassing mostly a complete hemithorax. The primary group underwent irradiation of supraclavicular, infraclavicular, axillary and parasternal lymphonodal region. Radiotherapy was combined with chemotherapy (<italic>n</italic>
 = 11). We assessed the PTV volume and its craniocaudal extension, the dose to the organs at risk, acute toxicity and survival.</p>
</sec>
<sec><title>Results</title>
<p>Median PTV was 2276 cm<sup>3</sup>
 (1476–6837 cm<sup>3</sup>
) with a median cranio-caudal extension of 28 cm (15–52 cm). The median dose to PTV was 40 Gy (32–60Gy). HT could be carried out in all patients without interruption. The acute toxicities were mild to moderate. The median LRFS and OS after radiotherapy was 21 and 57 months for the primary group versus 10 and 11 months for the recurrence group. Median PFS was 18 months (primary group) and 7 months (recurrence group).</p>
</sec>
<sec><title>Conclusions</title>
<p>HT is feasible for advanced thorax embracing target volumes with acceptable acute toxicity. Both curative and palliative indications can be considered good indications based on treatment volume and anatomical constellation.</p>
</sec>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>Helical tomo therapy</kwd>
<kwd>Breast cancer</kwd>
<kwd>Reirradiation</kwd>
<kwd>Chemoradiation</kwd>
<kwd>Acute toxicity</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Author(s) 2017</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Allemagne</li>
</country>
<region><li>Bavière</li>
<li>District de Haute-Bavière</li>
</region>
<settlement><li>Munich</li>
</settlement>
</list>
<tree><country name="Allemagne"><region name="Bavière"><name sortKey="Duma, M N" sort="Duma, M N" uniqKey="Duma M" first="M. N." last="Duma">M. N. Duma</name>
</region>
<name sortKey="Chizzali, B" sort="Chizzali, B" uniqKey="Chizzali B" first="B." last="Chizzali">B. Chizzali</name>
<name sortKey="Combs, S E" sort="Combs, S E" uniqKey="Combs S" first="S. E." last="Combs">S. E. Combs</name>
<name sortKey="Combs, S E" sort="Combs, S E" uniqKey="Combs S" first="S. E." last="Combs">S. E. Combs</name>
<name sortKey="Devecka, M" sort="Devecka, M" uniqKey="Devecka M" first="M." last="Devecka">M. Devecka</name>
<name sortKey="Duma, M N" sort="Duma, M N" uniqKey="Duma M" first="M. N." last="Duma">M. N. Duma</name>
<name sortKey="Heinrich, C" sort="Heinrich, C" uniqKey="Heinrich C" first="C." last="Heinrich">C. Heinrich</name>
<name sortKey="Heinrich, C" sort="Heinrich, C" uniqKey="Heinrich C" first="C." last="Heinrich">C. Heinrich</name>
<name sortKey="Kampfer, S" sort="Kampfer, S" uniqKey="Kampfer S" first="S." last="Kampfer">S. Kampfer</name>
<name sortKey="Mayinger, M" sort="Mayinger, M" uniqKey="Mayinger M" first="M." last="Mayinger">M. Mayinger</name>
<name sortKey="Schonknecht, C" sort="Schonknecht, C" uniqKey="Schonknecht C" first="C." last="Schönknecht">C. Schönknecht</name>
</country>
</tree>
</affiliations>
</record>

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Helical TomoTherapy for locally advanced or recurrent breast cancer

Helical TomoTherapy for locally advanced or recurrent breast cancer

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