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 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Clinical and Translational Oncology
Published in: Clinical and Translational Oncology 1/2014

01-01-2014 | Research Article

Dosimetric comparison of normal structures associated with accelerated partial breast irradiation and whole breast irradiation delivered by intensity modulated radiotherapy for early breast cancer after breast conserving surgery

Authors: S. Wu, Z. He, J. Guo, F. Li, Q. Lin, X. Guan

Published in: Clinical and Translational Oncology | Issue 1/2014

Login to get access

Abstract

Purpose

To assess the heart and lung dosimetry results associated with accelerated partial breast irradiation intensity-modulated radiotherapy (APBI-IMRT) and whole breast field-in-field intensity-modulated radiotherapy (WBI-FIF-IMRT).

Methods

A total of 29 patients with early-stage breast cancer after lumpectomy were included in this study. APBI-IMRT and WBI-FIF-IMRT plans were generated for each patient. The dosimetric parameters of ipsilateral lung and heart in both plans were then compared with and without radiobiological correction.

Results

With and without radiobiological correction, the volume of ipsilateral lung showed a substantially lower radiation exposure in APBI-IMRT with moderate to high doses (P < 0.05) but non-significant increases in volume of ipsilateral lung in 2.5 Gy than WBI-FIF-IMRT (P > 0.905).There was no significant difference in volume of ipsilateral lung receiving 1, 2.5, and 5 Gy between APBI-IMRT and WBI (P > 0.05) in patients with medial tumor location, although APBI-IMRT exposed more lung to 2.5 and 5 Gy. APBI-IMRT significantly decreases the volume of heart receiving low to high doses in left-sided breast cancer (P < 0.05).

Conclusion

APBI-IMRT can significantly spare the volume of heart and ipsilateral lung receiving moderate and high dose. Non-significant increases in volume of the ipsilateral lung exposed to low doses of radiation were observed for APBI-IMRT in comparison to WBI-FIF-IMRT, particularly in patients with medial tumor location. With the increasing interest in APBI-IMRT, our data may help clinicians individualize patient treatment decisions.
Literature
1.
Yarnold J, Bentzen SM, Coles C, Haviland J. Hypofractionated whole-breast radiotherapy for women with early breast cancer: myths and realities. Int J Radiat Oncol Biol Phys. 2011;79(1):1–9.PubMedCrossRef
2.
Veronesi U, Marubini E, Mariani L, Galimberti V, Luini A, Veronesi P, et al. Radiotherapy after breast-conserving surgery in small breast carcinoma: long-term results of a randomized trial. Ann Oncol. 2001;12:997–1003.PubMedCrossRef
3.
Mitsumori M, Hiraoka M. Current status of accelerated partial breast irradiation. Breast Cancer. 2008;15:101–7.PubMedCrossRef
4.
Wadasadawala T, Sarin R, Budrukkar A, Jalali R, Munshi A, Badwe R. Accelerated partial-breast irradiation vs conventional whole-breast radiotherapy in early breast cancer: a case-control study of disease control, cosmesis, and complications. J Cancer Res Ther. 2009;5:93–101.PubMedCrossRef
5.
Shah C, Antonucci JV, Wilkinson JB, Wallace M, Ghilezan M, Chen P, et al. Twelve-year clinical outcomes and patterns of failure with accelerated partial breast irradiation versus whole-breast irradiation: results of a matched-pair analysis. Radiother Oncol. 2011;100(2):210–4.PubMedCrossRef
6.
Li FY, He ZY, Xue M, Chen LX, Wu SG, Guan XX. Feasibility and acute toxicity of 3-dimensional conformal external-beam accelerated partial-breast irradiation for early-stage breast cancer after breast-conserving surgery in Chinese female patients. Chin Med J (Engl). 2011;124:1305–9.
7.
He ZY, Tong Q, Wu SG, Li FY, Lin HX, Guan XX. A comparison of quality of life of early breast cancer patients treated with accelerated partial breast irradiation versus whole breast irradiation in China. Breast Cancer Res Treat. 2012;133:545–52.PubMedCrossRef
8.
Offersen BV, Overgaard M, Kroman N, Overgaard J. Accelerated partial breast irradiation as part of breast conserving therapy of early breast carcinoma: a systematic review. Radiother Oncol. 2009;90:1–13.PubMedCrossRef
9.
Rusthoven KE, Carter DL, Howell K, Kercher JM, Henkenberns P, Hunter KL. et al.Accelerated partial-breast intensity-modulated radiotherapy results in improved dose distribution when compared with three-dimensional treatment-planning techniques. Int J Radiat Oncol Biol Phys. 2008;70:296–302.PubMedCrossRef
10.
Oliver M, Chen J, Wong E, Van Dyk J, Perera FA. Treatment planning study comparing whole breast radiation therapy against conformal, IMRT and tomotherapy for accelerated partial breast irradiation. Radiother Oncol 2007;82:317–323.
11.
Thilmann C, Zabel A, Nill S, Rhein B, Hoess A, Haering P, et al. Intensity-modulated radiotherapy of the female breast. Med Dosim. 2002;27:79–90.PubMedCrossRef
12.
Vicini F, Winter K, Straube W, Wong J, Pass H, Rabinovitch R, et al. 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
13.
Liao ZW, Guan XX, Li FY, He ZY, Xue M, Huang XY, et al. Accelerated partial breast irradiation: use of four-dimensional CT for target localization and assessment of intrafractional motion. Oncol Res. 2010;18:503–7.PubMedCrossRef
14.
Muller-Runkel R, Vijayakumar S. Equivalent total doses for different fractionation schemes, based on the linear quadratic model. Radiology. 1991;179:573–7.PubMed
15.
Hall EJ, Giaccia AJ. Clinical response of normal tissues. In: Hall EJ, Giaccia AJ, editors. Radiobiology for the Radiologist. 6th ed. Lippincott Williams and Wilkins Press: New York; 2006. p. 328–348.
16.
Jain AK, Vallow LA, Gale AA, Buskirk SJ. Does three-dimensional external beam partial breast irradiation spare lung tissue compared with standard whole breast irradiation? Int J Radiat Oncol Biol Phys. 2009;75:82–8.PubMedCrossRef
17.
Stewart AJ, O’Farrell DA, Cormack RA, Hansen JL, Khan AJ, Mutyala S, et al. Dose volume histogram analysis of normal structures associated with accelerated partial breast irradiation delivered by high dose rate brachytherapy and comparison with whole breast external beam radiotherapy fields. Radiat Oncol. 2008;3:39.PubMedCentralPubMedCrossRef
18.
Muren LP, Maurstad G, Hafslund R, Anker G, Dahl O. Cardiac and pulmonary doses and complication probabilities in standard and conformal tangential irradiation in conservative management of breast cancer. Radiother Oncol. 2002;62:173–83.PubMedCrossRef
19.
Recht A, Ancukiewicz M, Alm El-Din MA, Lu XQ, Martin C, Berman SM, et al. Lung dose–volume parameters and the risk of pneumonitis for patients treated with accelerated partial-breast irradiation using three-dimensional conformal radiotherapy. J Clin Oncol. 2009;27:3887–93.PubMedCrossRef
20.
Prochazka M, Hall P, Gagliardi G, Granath F, Nilsson BN, Shields PG, et al. Ionizing radiation and tobacco use increases the risk of a subsequent lung carcinoma in women with breast carcinoma: case-only design. J Clin Oncol. 2005;23:7467–74.PubMedCrossRef
21.
Inskip PD, Stovall M, Flannery JT. Lung cancer risk and radiation dose among women treated for breast cancer. J Natl Cancer Inst. 1994;86:983–8.PubMedCrossRef
22.
Darby SC, McGale P, Taylor CW, Peto R. Long-term mortality from heart disease and lung cancer after radiotherapy for early breast cancer: prospective cohort study of about 300 000 women in US SEER cancer registries. Lancet Oncol. 2005;6:557–65.PubMedCrossRef
23.
Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233–41.PubMedCrossRef
24.
Clarke M, Collins R, Darby S, Davies C, Elphinstone P, Evans E, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;366:2087–106.PubMed
25.
Bouillon K, Haddy N, Delaloge S, Garbay JR, Garsi JP, Brindel P, et al. Long-term cardiovascular mortality after radiotherapy for breast cancer. J Am Coll Cardiol. 2011;57:445–52.PubMedCrossRef
26.
Højris I, Overgaard M, Christensen JJ, Overgaard J. Morbidity and mortality of ischaemic heart disease in high-risk breast-cancer patients after adjuvant postmastectomy systemic treatment with or without radiotherapy: analysis of DBCG 82b and 82c randomised trials Radiotherapy Committee of the Danish Breast Cancer Cooperative Group. Lancet. 1999;354:1425–30.PubMedCrossRef
27.
Patt DA, Goodwin JS, Kuo YF, Freeman JL, Zhang DD, Buchholz TA, et al. Cardiac morbidity of adjuvant radiotherapy for breast cancer. J Clin Oncol. 2005;23:7475–82.PubMedCrossRef
28.
Hooning MJ, Botma A, Aleman BM, Baaijens MH, Bartelink H, Klijn JG, et al. Long-term risk of cardiovascular disease in 10-year survivors of breast cancer. J Natl Cancer Inst. 2007;99:365–75.PubMedCrossRef
29.
Schultz-Hector S, Trott KR. Radiation-induced cardiovascular diseases: is the epidemiologic evidence compatible with the radiobiologic data? Int J Radiat Oncol Biol Phys. 2007;67:10–8.PubMedCrossRef
30.
Kodama K, Fujiwara S, Yamada M, Kasagi F, Shimizu Y, Shigematsu I. Profiles of non-cancer diseases in atomic bomb survivors. World Health Stat Q. 1996;49:7–16.PubMed
Metadata
Title
Dosimetric comparison of normal structures associated with accelerated partial breast irradiation and whole breast irradiation delivered by intensity modulated radiotherapy for early breast cancer after breast conserving surgery
Authors
S. Wu
Z. He
J. Guo
F. Li
Q. Lin
X. Guan
Publication date
01-01-2014
Publisher
Springer Milan
Published in
Clinical and Translational Oncology / Issue 1/2014
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI
https://doi.org/10.1007/s12094-013-1044-y

Other articles of this Issue 1/2014

Clinical and Translational Oncology 1/2014 Go to the issue

Review Article

Objective: tumor. Strategies of drug targeting at the tumor mass level

Research Article

Diacylglycerol kinase η modulates oncogenic properties of lung cancer cells

Research Article

Does the extent of lymph nodes dissection affect the prognosis of resected stage IA non-small cell lung cancer?

Research Article

Clinical significance of FOXP3 expression in human gliomas

Brief Research Article

Variants in phospholipid metabolism and upstream regulators and non-small cell lung cancer susceptibility

Research Article

Statin use and peripheral blood progenitor cells mobilization in patients with multiple myeloma
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