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Axillary irradiation omitting axillary dissection in breast cancer: is there a role for shoulder-sparing proton therapy?

Identifieur interne : 000D85 ( PubMed/Corpus ); précédent : 000D84; suivant : 000D86

Axillary irradiation omitting axillary dissection in breast cancer: is there a role for shoulder-sparing proton therapy?

Auteurs : P. Farace ; M A Deidda ; M. Amichetti

Source :

The British journal of radiology [ 1748-880X ] ; 2015.

RBID : pubmed:26153903

English descriptors

KwdEn :
- Axilla, Breast Neoplasms (radiotherapy), Female, Humans, Lymph Node Excision, Proton Therapy (methods), Quality of Life, Range of Motion, Articular, Shoulder (physiopathology), Shoulder (radiation effects).
MESH :
- methods : Proton Therapy.
- physiopathology : Shoulder.
- radiation effects : Shoulder.
- radiotherapy : Breast Neoplasms.
- Axilla, Female, Humans, Lymph Node Excision, Quality of Life, Range of Motion, Articular.

Abstract

The recent EORTC 10981-22023 AMAROS trial showed that axillary radiotherapy and axillary lymph node dissection provide comparable local control and reduced lymphoedema in the irradiated group. However, no significant differences between the two groups in range of motion and quality of life were reported. It has been acknowledged that axillary irradiation could have induced some toxicity, particularly shoulder function impairment. In fact, conventional breast irradiation by tangential beams has to be modified to achieve full-dose coverage of the axillary nodes, including in the treatment field a larger portion of the shoulder structures. In this scenario, alternative irradiation techniques were discussed. Compared with modern photon techniques, axillary irradiation by proton therapy has the potential for sparing the shoulder without detrimental increase of the medium-to-low doses to the other normal tissues.

DOI: 10.1259/bjr.20150274
PubMed: 26153903

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pubmed:26153903

Le document en format XML

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<author><name sortKey="Farace, P" sort="Farace, P" uniqKey="Farace P" first="P" last="Farace">P. Farace</name>
<affiliation><nlm:affiliation>1 Proton Therapy Centre, Azienda Provinciale per i Servizi Sanitari, Trento, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Deidda, M A" sort="Deidda, M A" uniqKey="Deidda M" first="M A" last="Deidda">M A Deidda</name>
<affiliation><nlm:affiliation>2 Radiotherapy Department, Regional Oncological Hospital, Cagliari, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Amichetti, M" sort="Amichetti, M" uniqKey="Amichetti M" first="M" last="Amichetti">M. Amichetti</name>
<affiliation><nlm:affiliation>1 Proton Therapy Centre, Azienda Provinciale per i Servizi Sanitari, Trento, Italy.</nlm:affiliation>
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<author><name sortKey="Farace, P" sort="Farace, P" uniqKey="Farace P" first="P" last="Farace">P. Farace</name>
<affiliation><nlm:affiliation>1 Proton Therapy Centre, Azienda Provinciale per i Servizi Sanitari, Trento, Italy.</nlm:affiliation>
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<author><name sortKey="Deidda, M A" sort="Deidda, M A" uniqKey="Deidda M" first="M A" last="Deidda">M A Deidda</name>
<affiliation><nlm:affiliation>2 Radiotherapy Department, Regional Oncological Hospital, Cagliari, Italy.</nlm:affiliation>
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<author><name sortKey="Amichetti, M" sort="Amichetti, M" uniqKey="Amichetti M" first="M" last="Amichetti">M. Amichetti</name>
<affiliation><nlm:affiliation>1 Proton Therapy Centre, Azienda Provinciale per i Servizi Sanitari, Trento, Italy.</nlm:affiliation>
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<series><title level="j">The British journal of radiology</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Axilla</term>
<term>Breast Neoplasms (radiotherapy)</term>
<term>Female</term>
<term>Humans</term>
<term>Lymph Node Excision</term>
<term>Proton Therapy (methods)</term>
<term>Quality of Life</term>
<term>Range of Motion, Articular</term>
<term>Shoulder (physiopathology)</term>
<term>Shoulder (radiation effects)</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Proton Therapy</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Shoulder</term>
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<keywords scheme="MESH" qualifier="radiation effects" xml:lang="en"><term>Shoulder</term>
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<keywords scheme="MESH" qualifier="radiotherapy" xml:lang="en"><term>Breast Neoplasms</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Axilla</term>
<term>Female</term>
<term>Humans</term>
<term>Lymph Node Excision</term>
<term>Quality of Life</term>
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<front><div type="abstract" xml:lang="en">The recent EORTC 10981-22023 AMAROS trial showed that axillary radiotherapy and axillary lymph node dissection provide comparable local control and reduced lymphoedema in the irradiated group. However, no significant differences between the two groups in range of motion and quality of life were reported. It has been acknowledged that axillary irradiation could have induced some toxicity, particularly shoulder function impairment. In fact, conventional breast irradiation by tangential beams has to be modified to achieve full-dose coverage of the axillary nodes, including in the treatment field a larger portion of the shoulder structures. In this scenario, alternative irradiation techniques were discussed. Compared with modern photon techniques, axillary irradiation by proton therapy has the potential for sparing the shoulder without detrimental increase of the medium-to-low doses to the other normal tissues.</div>
</front>
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<Title>The British journal of radiology</Title>
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<Abstract><AbstractText>The recent EORTC 10981-22023 AMAROS trial showed that axillary radiotherapy and axillary lymph node dissection provide comparable local control and reduced lymphoedema in the irradiated group. However, no significant differences between the two groups in range of motion and quality of life were reported. It has been acknowledged that axillary irradiation could have induced some toxicity, particularly shoulder function impairment. In fact, conventional breast irradiation by tangential beams has to be modified to achieve full-dose coverage of the axillary nodes, including in the treatment field a larger portion of the shoulder structures. In this scenario, alternative irradiation techniques were discussed. Compared with modern photon techniques, axillary irradiation by proton therapy has the potential for sparing the shoulder without detrimental increase of the medium-to-low doses to the other normal tissues.</AbstractText>
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<CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Radiother Oncol. 2015 Jan;114(1):3-10</RefSource>
<PMID Version="1">25630428</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="Cites"><RefSource>Lancet Oncol. 2015 Feb;16(2):e54</RefSource>
<PMID Version="1">25638681</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="Cites"><RefSource>Breast Cancer Res Treat. 2009 Jul;116(1):1-15</RefSource>
<PMID Version="1">19031114</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="Cites"><RefSource>Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3):685-97</RefSource>
<PMID Version="1">19615828</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="Cites"><RefSource>Br J Radiol. 2010 Dec;83(996):1072-6</RefSource>
<PMID Version="1">21088091</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="Cites"><RefSource>PM R. 2011 Nov;3(11):1041-54</RefSource>
<PMID Version="1">22108231</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="Cites"><RefSource>Int J Radiat Oncol Biol Phys. 2013 Jul 1;86(3):484-90</RefSource>
<PMID Version="1">23523326</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="Cites"><RefSource>Strahlenther Onkol. 2013 Nov;189(11):967-71</RefSource>
<PMID Version="1">24104869</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="Cites"><RefSource>Acta Oncol. 2014 Apr;53(4):521-9</RefSource>
<PMID Version="1">24495044</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="Cites"><RefSource>Radiother Oncol. 2014 Mar;110(3):471-6</RefSource>
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<CommentsCorrections RefType="Cites"><RefSource>PLoS One. 2014;9(5):e96748</RefSource>
<PMID Version="1">24816774</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="Cites"><RefSource>Lancet Oncol. 2014 Nov;15(12):1303-10</RefSource>
<PMID Version="1">25439688</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="Cites"><RefSource>Int J Radiat Oncol Biol Phys. 2015 Feb 1;91(2):427-34</RefSource>
<PMID Version="1">25636765</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="Cites"><RefSource>Lancet Oncol. 2015 Feb;16(2):e53-4</RefSource>
<PMID Version="1">25638680</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="Cites"><RefSource>Br J Radiol. 2015 Jul;88(1051):20150071</RefSource>
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<MeshHeadingList><MeshHeading><DescriptorName UI="D001365" MajorTopicYN="N">Axilla</DescriptorName>
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<MeshHeading><DescriptorName UI="D011788" MajorTopicYN="N">Quality of Life</DescriptorName>
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<MeshHeading><DescriptorName UI="D016059" MajorTopicYN="N">Range of Motion, Articular</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012782" MajorTopicYN="N">Shoulder</DescriptorName>
<QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName>
<QualifierName UI="Q000528" MajorTopicYN="Y">radiation effects</QualifierName>
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Axillary irradiation omitting axillary dissection in breast cancer: is there a role for shoulder-sparing proton therapy?

Axillary irradiation omitting axillary dissection in breast cancer: is there a role for shoulder-sparing proton therapy?

Source :

English descriptors

Abstract

Links to Exploration step

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki