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 : 003186 ( Pmc/Corpus ); précédent : 003185; suivant : 003187Comparison 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 ; Sergey Vasilevich Kanaev ; Vladimir Fedorovich Semiglazov ; Ludmila Alekseevna Jukova ; Pavel Ivanovich KrzhivitckiySource :
- 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.
Url:
DOI: 10.1016/j.rpor.2014.06.001
PubMed: 25535581
PubMed Central: 4268592
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Comparison of two treatment strategies for irradiation of regional lymph nodes in patients with breast cancer: Lymph flow guided portals versus standard radiation fields</title><author><name sortKey="Novikov, Sergey Nikolaevich" sort="Novikov, Sergey Nikolaevich" uniqKey="Novikov S" first="Sergey Nikolaevich" last="Novikov">Sergey Nikolaevich Novikov</name><affiliation><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></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><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></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><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></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><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></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><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></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25535581</idno><idno type="pmc">4268592</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4268592</idno><idno type="RBID">PMC:4268592</idno><idno type="doi">10.1016/j.rpor.2014.06.001</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">003186</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">003186</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Comparison of two treatment strategies for irradiation of regional lymph nodes in patients with breast cancer: Lymph flow guided portals versus standard radiation fields</title><author><name sortKey="Novikov, Sergey Nikolaevich" sort="Novikov, Sergey Nikolaevich" uniqKey="Novikov S" first="Sergey Nikolaevich" last="Novikov">Sergey Nikolaevich Novikov</name><affiliation><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></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><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></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><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></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><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></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><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></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><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Rep Pract Oncol Radiother</journal-id><journal-title-group><journal-title>Reports of Practical Oncology and Radiotherapy</journal-title></journal-title-group><issn pub-type="ppub">1507-1367</issn><issn pub-type="epub">2083-4640</issn></journal-meta><article-meta><article-id pub-id-type="pmid">25535581</article-id><article-id pub-id-type="pmc">4268592</article-id><article-id pub-id-type="publisher-id">S1507-1367(14)00120-5</article-id><article-id pub-id-type="doi">10.1016/j.rpor.2014.06.001</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Research Article</subject></subj-group></article-categories><title-group><article-title>Comparison of two treatment strategies for irradiation of regional lymph nodes in patients with breast cancer: Lymph flow guided portals versus standard radiation fields</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Novikov</surname><given-names>Sergey Nikolaevich</given-names></name><email>krokon@mail.ru</email><xref rid="aff0005" ref-type="aff">a</xref><xref rid="cor0005" ref-type="corresp">⁎</xref></contrib><contrib contrib-type="author"><name><surname>Kanaev</surname><given-names>Sergey Vasilevich</given-names></name><xref rid="aff0005" ref-type="aff">a</xref></contrib><contrib contrib-type="author"><name><surname>Semiglazov</surname><given-names>Vladimir Fedorovich</given-names></name><xref rid="aff0010" ref-type="aff">b</xref></contrib><contrib contrib-type="author"><name><surname>Jukova</surname><given-names>Ludmila Alekseevna</given-names></name><xref rid="aff0005" ref-type="aff">a</xref></contrib><contrib contrib-type="author"><name><surname>Krzhivitckiy</surname><given-names>Pavel Ivanovich</given-names></name><xref rid="aff0005" ref-type="aff">a</xref></contrib></contrib-group><aff id="aff0005"><label>a</label>Department of Radiation Oncology and Nuclear Medicine, N.N. Petrov Institute Oncology, Leningradskaya, 68, Pesochny-2, 194291 St. Petersburg, Russia</aff><aff id="aff0010"><label>b</label>Department of Surgery No. 1 (Breast Cancer), N.N. Petrov Institute Oncology, Leningradskaya, 68, Pesochny-2, 194291 St. Petersburg, Russia</aff><author-notes><corresp id="cor0005"><label>⁎</label><italic>Corresponding author</italic>. Tel.: +7 9500437996. <email>krokon@mail.ru</email></corresp></author-notes><pub-date pub-type="epub"><day>19</day><month>7</month><year>2014</year></pub-date><pub-date pub-type="collection"><month>1</month><year>2015</year></pub-date><volume>20</volume><issue>1</issue><fpage>27</fpage><lpage>31</lpage><history><date date-type="received"><day>3</day><month>1</month><year>2014</year></date><date date-type="rev-recd"><day>5</day><month>5</month><year>2014</year></date><date date-type="accepted"><day>23</day><month>6</month><year>2014</year></date></history><permissions><copyright-statement>© 2015 Greater Poland Cancer Centre. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.</copyright-statement><copyright-year>2014</copyright-year><copyright-holder>Greater Poland Cancer Centre</copyright-holder></permissions><abstract><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></abstract><kwd-group><title>Keywords</title><kwd>Breast cancer</kwd><kwd>Radiotherapy</kwd><kwd>Sentinel lymph-nodes</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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