Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Breast Cancer
Published in: Breast Cancer 1/2008

01-01-2008 | Special Feature: Original Article

Feasibility of accelerated partial breast irradiation using three-dimensional conformal radiation therapy for Japanese women: a theoretical plan using six patients’ CT data

Authors: Yasuhiro Kosaka, Michihide Mitsumori, Chikako Yamauchi, Yuichiro Narita, Masahiro Hiraoka

Published in: Breast Cancer | Issue 1/2008

Login to get access

Abstract

Background

Several methods have been reported for accelerated partial breast irradiation (APBI), but in Japan, there are few facilities where brachytherapy or intra-operative radiotherapy is available. Japanese women have smaller physiques than American women in general. Thus, we developed external beam plans for APBI using computed tomography (CT) data of Japanese patients, to investigate whether APBI using three-dimensional conformal radiation therapy is safely applicable for Japanese women, while verifying the dose distributions.

Methods

We used CT data from six Japanese patients with early breast cancer, which were obtained in routine clinical practice during whole breast irradiation (WBI) after wide excision, and made 32 APBI plans according to the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-39 and the Radiation Therapy Oncology Group (RTOG) 0413 protocol, which compared APBI with WBI. We then investigated the compliance to the dose constraints of the protocol.

Results

None of 16 plans for the medial regions met the dose constraints regardless of laterality of the breast. The major reason was overdosage to the contralateral breast. Thirteen of 16 plans (81%) for the lateral regions met the dose constraints. The remaining three plans (19%) did not meet the dose limitation of the uninvolved normal breast, suggesting that a large ratio of the target to the breast was problematic.

Conclusions

In Japanese women, patients with a laterally located small tumor can be candidates for APBI using three-dimensional conformal radiation therapy.
Literature
1.
Fisher B, Bryant J, Wolmark N, Mamounas E, Brown A, Fisher ER, Wickerham DL, Begovic M, DeCillis A, Robidoux A, Margolese RG, Cruz AB Jr, Hoehn JL, Lees AW, Dimitrov NV, Bear HD. Effect of preoperative chemotherapy on the outcome of women with operable breast cancer. J Clin Oncol 1998;16:2672–85.PubMed
2.
Sachelarie I, Grossbard ML, Chadha M, Feldman S, Ghesani M, Blum RH. Primary systemic therapy of breast cancer. Oncologist 2006;11:574–89.PubMedCrossRef
3.
Lingos TI, Recht A, Vicini F, Abner A, Silver B, Harris JR. Radiation pneumonitis in breast cancer patients treated with conservative surgery and radiation therapy. Int J Radiat Oncol Biol Phys. 1991;21:355–60.PubMed
4.
5.
Liljegren G, Holmberg L, Westman G. The cosmetic outcome in early breast cancer treated with sector resection with or without radiotherapy. Uppsala-Orebro Breast Cancer Study Group. Eur J Cancer. 1993;29A:2083–9.PubMedCrossRef
6.
Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, Aguilar M, Marubini E. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347:1227–32.PubMedCrossRef
7.
Liljegren G, Holmberg L, Bergh J, Lindgren A, Tabar L, Nordgren H, Adami HO. 10-Year results after sector resection with or without postoperative radiotherapy for stage I breast cancer: a randomized trial. J Clin Oncol. 1999;17:2326–33.PubMed
8.
King TA, Bolton JS, Kuske RR, Fuhrman GM, Scroggins TG, Jiang XZ. Long-term results of wide-field brachytherapy as the sole method of radiation therapy after segmental mastectomy for T(is,1,2) breast cancer. Am J Surg. 2000;180:299–304.PubMedCrossRef
9.
Polgar C, Major T, Fodor J, Nemeth G, Orosz Z, Sulyok Z, Udvarhelyi N, Somogyi A, Takacsi-Nagy Z, Lovey K, Agoston P, Kasler M. High-dose-rate brachytherapy alone versus whole breast radiotherapy with or without tumor bed boost after breast-conserving surgery: seven-year results of a comparative study. Int J Radiat Oncol Biol Phys. 2004;60:1173–81.PubMedCrossRef
10.
Shah NM, Tenenholz T, Arthur D, DiPetrillo T, Bornstein B, Cardarelli G, Zheng Z, Rivard MJ, Kaufman S, Wazer DE. MammoSite and interstitial brachytherapy for accelerated partial breast irradiation: factors that affect toxicity and cosmesis. Cancer. 2004;101:727–34.PubMedCrossRef
11.
Tsai PI, Ryan M, Meek K, Ryoo MC, Tome M, Takasugi J, Haigh P, Difronzo LA. Accelerated partial breast irradiation using the MammoSite device: early technical experience and short-term clinical follow-up. Am Surg. 2006;72:929–34.PubMed
12.
Baglan KL, Sharpe MB, Jaffray D, Frazier RC, Fayad J, Kestin LL, Remouchamps V, Martinez AA, Wong J, Vicini FA. Accelerated partial breast irradiation using 3D conformal radiation therapy (3D-CRT). Int J Radiat Oncol Biol Phys. 2003;55:302–11.PubMedCrossRef
13.
Vicini FA, Remouchamps V, Wallace M, Sharpe M, Fayad J, Tyburski L, Letts N, Kestin L, Edmundson G, Pettinga J, Goldstein NS, Wong J. Ongoing clinical experience utilizing 3D conformal external beam radiotherapy to deliver partial-breast irradiation in patients with early-stage breast cancer treated with breast-conserving therapy. Int J Radiat Oncol Biol Phys. 2003;57:1247–53.PubMedCrossRef
14.
Rivard MJ, Davis SD, DeWerd LA, Rusch TW, Axelrod S. Calculated and measured brachytherapy dosimetry parameters in water for the Xoft Axxent X-Ray Source: an electronic brachytherapy source. Med Phys. 2006;33:4020–32.PubMedCrossRef
15.
Veronesi U, Orecchia R, Luini A, Gatti G, Intra M, Zurrida S, Ivaldi G, Tosi G, Ciocca M, Tosoni A, De Lucia F. A preliminary report of intraoperative radiotherapy (IORT) in limited-stage breast cancers that are conservatively treated. Eur J Cancer. 2001 37:2178–83.PubMedCrossRef
16.
Arthur DW, Vicini FA. Accelerated partial breast irradiation as a part of breast conservation therapy. J Clin Oncol. 2005;23:1726–35.PubMedCrossRef
17.
Vicini F, Winter K, Straube W, Wong J, Pass H, Rabinovitch R, Chafe S, Arthur D, Petersen I, McCormick B. A phase I/II trial to evaluate three-dimensional conformal radiation therapy confined to the region of the lumpectomy cavity for Stage I/II breast carcinoma: initial report of feasibility and reproducibility of Radiation Therapy Oncology Group (RTOG) Study 0319. Int J Radiat Oncol Biol Phys. 2005;63:1531–7.PubMedCrossRef
18.
19.
Nose T, Komoike Y, Yoshida K, Koizumi M, Motomura K, Kasugai T, Inaji H, Nishiyama K, Koyama H, Kozuka T, Gomi K, Oguchi M, Akahashi Y, Sumida I, Yamashita T. A pilot study of wider use of accelerated partial breast irradiation: intraoperative margin-directed re-excision combined with sole high-dose-rate interstitial brachytherapy. Breast Cancer. 2006;13:289–99.PubMedCrossRef
20.
Taghian AG, Kozak KR, Doppke KP, Katz A, Smith BL, Gadd M, Specht M, Hughes K, Braaten K, Kachnic LA, Recht A, Powell SN. Initial dosimetric experience using simple three-dimensional conformal external-beam accelerated partial-breast irradiation. Int J Radiat Oncol Biol Phys. 2006;64:1092–9.PubMedCrossRef
21.
Vicini FA, Kestin LL, Goldstein NS. Defining the clinical target volume for patients with early-stage breast cancer treated with lumpectomy and accelerated partial breast irradiation: a pathologic analysis. Int J Radiat Oncol Biol Phys. 2004;60:722–30.PubMedCrossRef
Metadata
Title
Feasibility of accelerated partial breast irradiation using three-dimensional conformal radiation therapy for Japanese women: a theoretical plan using six patients’ CT data
Authors
Yasuhiro Kosaka
Michihide Mitsumori
Chikako Yamauchi
Yuichiro Narita
Masahiro Hiraoka
Publication date
01-01-2008
Publisher
Springer Japan
Published in
Breast Cancer / Issue 1/2008
Print ISSN: 1340-6868
Electronic ISSN: 1880-4233
DOI
https://doi.org/10.1007/s12282-007-0013-0

Other articles of this Issue 1/2008

Breast Cancer 1/2008 Go to the issue

Special Feature

New trends in radiation therapy as a component of breast conserving therapy

Editorial

Message from the editor-in-chief

Conference Paper

Heterogeneity of breast cancer and implications of adjuvant chemotherapy

Conference Paper

Development of HER2-antagonistic peptides as novel anti-breast cancer drugs by in silico methods

Conference Paper

Breakthrough for neoadjuvant chemotherapy

Special Feature: Original Article

Patients’ subjective evaluation of early and late sequelae in patients with breast cancer irradiated with short fractionation for breast conservation therapy: comparison with conventional fractionation
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits