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Ghazbani A, Abdolahi M, Mansourzadeh MJ, BasirianJahromi R, Behzadipour S, Mohseni Azad A, Talebzadeh B, Khosravi A, Hamidi A. Knowledge domain and emerging trends in brachytherapy: A scientometric analysis. PRECISION RADIATION ONCOLOGY 2022. [DOI: 10.1002/pro6.1171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Arash Ghazbani
- Student Research Committee Bushehr University of Medical Sciences Bushehr Iran
| | - Mohammad Abdolahi
- Department of Radiology Faculty of Paramedicine Bushehr University of Medical Sciences Bushehr Iran
| | | | - Reza BasirianJahromi
- Department of Medical Library and Information Sciences Faculty of Paramedicine Bushehr University of Medical Sciences Bushehr Iran
| | - Sina Behzadipour
- Student Research Committee Bushehr University of Medical Sciences Bushehr Iran
| | - Anali Mohseni Azad
- Department of Surgery Faculty of Medicine Bushehr University of Medical Sciences Bushehr Iran
| | | | - Abdolrasoul Khosravi
- Department of Medical Library and Information Sciences Faculty of Paramedicine Bushehr University of Medical Sciences Bushehr Iran
| | - Ali Hamidi
- Department of Medical Library and Information Sciences Faculty of Paramedicine Bushehr University of Medical Sciences Bushehr Iran
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2
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Stephens H, Deans C, Schlect D, Kairn T. Development of a method for treating lower-eyelid carcinomas using superficial high dose rate brachytherapy. Phys Eng Sci Med 2020; 43:1317-1325. [PMID: 33123861 DOI: 10.1007/s13246-020-00935-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 10/03/2020] [Indexed: 11/26/2022]
Abstract
In this study, a method was developed for delivering high dose rate (HDR) brachytherapy treatments to basal cell carcinomas (BCCs) as well as squamous cell carcinomas (SCCs) of the lower eyelid via superficial catheters. Clinically-realistic BCC/SCC treatment areas were marked in the lower-eyelid region on a head phantom and several arrangements of catheters and bolus were trialled for treating those areas. The use of one or two catheters of different types was evaluated, and sources of dosimetric uncertainty (including air gaps) were evaluated and mitigated. Test treatments were planned for delivery with an iridium-192 source, using the Oncentra Brachy treatment planning system (Elekta AB, Stockholm, Sweden). Dose distributions were evaluated using radiochromic film. The proposed method was shown to be clinically viable, for using superficial HDR brachytherapy to overcome anatomical difficulties and create non-surgical treatments for BCC and SCC of the lower eyelid.
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Affiliation(s)
- H Stephens
- Chermside Medical Complex, Ground Floor, 956 Gympie Road, Chermside, Qld, 4032, Australia.
- School of Physical Sciences, University of Adelaide, North Terrace, Adelaide, SA, 5005, Australia.
| | - C Deans
- Chermside Medical Complex, Ground Floor, 956 Gympie Road, Chermside, Qld, 4032, Australia
- Icon Integrated Cancer Centre, 9 McLennan Ct, North Lakes, Qld, 4509, Australia
| | - D Schlect
- Chermside Medical Complex, Ground Floor, 956 Gympie Road, Chermside, Qld, 4032, Australia
| | - T Kairn
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Qld, 4029, Australia
- Science and Engineering Faculty, Queensland University of Technology, Gardens Point, Qld, 4001, Australia
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3
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La Rocca E, Lozza L, D' Ippolito E, Dispinzieri M, Giandini C, Bonfantini F, Valdagni R, Folli S, Pignoli E, Di Cosimo S, De Santis MC. VMAT partial-breast irradiation: acute toxicity of hypofractionated schedules of 30 Gy in five daily fractions. Clin Transl Oncol 2020; 22:1802-1808. [PMID: 32128672 DOI: 10.1007/s12094-020-02319-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 02/08/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE To report acute toxicities in breast cancer (BC) patients (pts) recruited in a prospective trial and treated with accelerated partial-breast irradiation (APBI) using Volumetric Modulated Arc Therapy (VMAT) delivered with a hypofractionated schedule. METHODS From March 2014 to June 2019, pts with early-stage BC (Stage I), who underwent breast conservative surgery (BCS), were recruited in a prospective study started at the National Cancer Institute of Milan. Pts received APBI with a hypofractionated schedule of 30 Gy in five daily fractions. Radiotherapy treatment (RT) was delivered using VMAT. Acute toxicity was assessed according to RTOG/EORTC criteria at the end of RT. RESULTS Between March 2014 and June 2019, 151 pts were enrolled in this study. 79 Pts had right-side and 72 had left-side breast cancer. Median age was 69 (range 43-92). All pts presented with pathological stage IA BC, molecular classification was Luminal A in 128/151 (85%) and Luminal B in 23/151 (15%) cases. Acute toxicity, assessed at the end of RT, consisted of G1 erythema in 37/151 (24. 5%) pts and skin toxicities higher than G1, did not occur. Fibrosis G1 and G2 were reported in 41/151 (27. 1%) pts and in 2/151 pts (1. 3%), respectively. Edema G1 occurred in 8/151 (5. 3%) pts and asthenia G1 occurred in 1/151 (0. 6%) pts. CONCLUSIONS APBI with VMAT proved to be feasible and can be a valid alternative treatment option after BCS in selected early breast cancer pts according to ASTRO guidelines. A longer follow-up is needed to assess late toxicity.
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Affiliation(s)
- E La Rocca
- Radiotherapy Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Department of Oncology and Hemato-Oncology, Università Degli Studi Di Milan, Milano, Italy
| | - L Lozza
- Radiotherapy Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - E D' Ippolito
- Medical Physics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Dispinzieri
- Radiotherapy Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - C Giandini
- Radiotherapy Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Department of Oncology and Hemato-Oncology, Università Degli Studi Di Milan, Milano, Italy
| | - F Bonfantini
- Medical Physics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Radiotherapy and Oncology Unit, ASST Bergamo Ovest, Treviglio, Italy
| | - R Valdagni
- Department of Oncology and Hemato-Oncology, Università Degli Studi Di Milan, Milano, Italy.,Radiation Oncology 1 and Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Folli
- Breast Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - E Pignoli
- Medical Physics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Di Cosimo
- Biomarker Unit, Department of Applied Research and Technological Development (DRAST), Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M C De Santis
- Radiotherapy Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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Abdullayev OA, Gaitan AS, Salim N, Sergeyev GS, Marmazeyev IV, Chesnulis E, Goryainov SA, Krivoshapkin AL. [Repetitive resection and intrasurgery radiation therapy of brain malignant gliomas: history of question and modern state of problem]. ZHURNAL VOPROSY NEĬROKHIRURGII IMENI N. N. BURDENKO 2019; 83:101-108. [PMID: 31825381 DOI: 10.17116/neiro201983051101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Numerous studies have shown that the degree of primary resection of malignant gliomas of the brain (MG) directly correlates with rates of relapse-free and overall patient survival. Currently, there is no unequivocal opinion regarding the indications and effectiveness of repeated resection in relapse of MG after combined treatment. Surgical intervention, taking into account the pathomorphological features of these tumors, is not healing and should be supplemented with certain methods of adjuvant treatment. The article reviews and analyzes publications devoted to repeated resection and various methods of intraoperative radiation therapy in the treatment of MG. Based on the analysis, the authors of the article came to the conclusion that it is advisable to start their own research on the use of intraoperative balloon brachytherapy in the treatment of recurrent MG based on modern technological solutions.
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Affiliation(s)
- O A Abdullayev
- Novosibirsk State Medical University Ministry of Health, Novosibirsk, Russia; European Medical Center, Moscow, Russia
| | | | - N Salim
- European Medical Center, Moscow, Russia
| | | | | | - E Chesnulis
- Hirslanden Clinic, Center of Neurosurgery, Zurich, Switzerland
| | | | - A L Krivoshapkin
- Novosibirsk State Medical University Ministry of Health, Novosibirsk, Russia; European Medical Center, Moscow, Russia
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5
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Krivoshapkin A, Gaytan A, Salim N, Abdullaev O, Sergeev G, Marmazeev I, Cesnulis E, Killeen T. Repeat Resection and Intraoperative Radiotherapy for Malignant Gliomas of the Brain: A History and Review of Current Techniques. World Neurosurg 2019; 132:356-362. [PMID: 31536810 DOI: 10.1016/j.wneu.2019.09.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 02/06/2023]
Abstract
The degree of primary resection of malignant brain gliomas (MBGs) has correlated positively with progression-free and overall survival. The indications for surgery and reoperation in MBG relapse remain controversial. Surgery will not be curative and should be followed by adjuvant treatment. We reviewed the reported studies with respect to repeat resection and the various methods of intraoperative radiotherapy for MBGs from the initial experience with high-energy linear accelerators in Japan to modern, integrated brachytherapy solutions using solid and balloon applicators. Because of the findings from our review, we have begun to research into the use of intraoperative balloon brachytherapy for recurrent MBGs.
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Affiliation(s)
- Alexey Krivoshapkin
- Novosibirsk State Medical University, Novosibirsk, Russian Federation; European Medical Center, Moscow, Russian Federation.
| | | | - Nidal Salim
- European Medical Center, Moscow, Russian Federation
| | - Orkhan Abdullaev
- Novosibirsk State Medical University, Novosibirsk, Russian Federation; European Medical Center, Moscow, Russian Federation
| | - Gleb Sergeev
- European Medical Center, Moscow, Russian Federation
| | | | - Evaldas Cesnulis
- Department of Neurosurgery, Klinik Hirslanden, Zurich, Switzerland
| | - Tim Killeen
- Department of Neurosurgery, Klinik Hirslanden, Zurich, Switzerland
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Shih YH, Peng CL, Weng MF, Chiang PF, Luo TY, Lin XZ. Evaluation Efficacy of Rhenium-188-Loaded Micro-particles for Radiotherapy in a Mouse Model of Hepatocellular Carcinoma. Mol Pharm 2019; 16:1083-1091. [DOI: 10.1021/acs.molpharmaceut.8b01083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Ying-Hsia Shih
- Isotope Application Division, Institute of Nuclear Energy Research, Taoyuan 32546, Taiwan
| | - Cheng-Liang Peng
- Isotope Application Division, Institute of Nuclear Energy Research, Taoyuan 32546, Taiwan
| | - Mao-Feng Weng
- Isotope Application Division, Institute of Nuclear Energy Research, Taoyuan 32546, Taiwan
| | - Ping-Fang Chiang
- Isotope Application Division, Institute of Nuclear Energy Research, Taoyuan 32546, Taiwan
| | - Tsai-Yueh Luo
- Isotope Application Division, Institute of Nuclear Energy Research, Taoyuan 32546, Taiwan
| | - Xi-Zhang Lin
- Department of Internal Medicine, National Cheng Kung University, Tainan 704, Taiwan
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Chan TY, Tang JI, Tan PW, Roberts N. Dosimetric evaluation and systematic review of radiation therapy techniques for early stage node-negative breast cancer treatment. Cancer Manag Res 2018; 10:4853-4870. [PMID: 30425577 PMCID: PMC6205528 DOI: 10.2147/cmar.s172818] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Radiation therapy (RT) is essential in treating women with early stage breast cancer. Early stage node-negative breast cancer (ESNNBC) offers a good prognosis; hence, late effects of breast RT becomes increasingly important. Recent literature suggests a potential for an increase in cardiac and pulmonary events after RT. However, these studies have not taken into account the impact of newer and current RT techniques that are now available. Hence, this review aimed to evaluate the clinical evidence for each technique and determine the optimal radiation technique for ESNNBC treatment. Currently, six RT techniques are consistently used and studied: 1) prone positioning, 2) proton beam RT, 3) intensity-modulated RT, 4) breath-hold, 5) partial breast irradiation, and 6) intraoperative RT. These techniques show dosimetric promise. However, limited data on late cardiac and pulmonary events exist due to challenges in long-term follow-up. Moving forward, future studies are needed to validate the efficacy and clinical outcomes of these current techniques.
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Affiliation(s)
- Tabitha Y Chan
- Department of Radiation Oncology, National University Cancer Institute, Singapore, Singapore,
| | - Johann I Tang
- Department of Radiation Oncology, National University Cancer Institute, Singapore, Singapore,
| | - Poh Wee Tan
- Department of Radiation Oncology, National University Cancer Institute, Singapore, Singapore,
| | - Neill Roberts
- Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK
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Lee J, Jung JH, Kim WW, Moon SH, Jeong JH, Park JY, Jeong JY, Lee H, Sohn IB, Kim CH, Park HY. Comparison of laser ablation using multidirectional and forward-firing fibers in breast cancer. MINIM INVASIV THER 2018; 27:292-299. [DOI: 10.1080/13645706.2018.1427605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Jeeyeon Lee
- Department of Surgery, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Jin Hyang Jung
- Department of Surgery, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Wan Wook Kim
- Department of Surgery, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - So Hyang Moon
- Department of Surgery, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Jae-Hwan Jeong
- Cell and Matrix Research Institute, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Ji-Young Park
- Department of Pathology, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Ji Yun Jeong
- Department of Pathology, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Ho Lee
- School of Mechanical Engineering, Kyungpook National University, Daegu, Republic of Korea
| | - Ik-Bu Sohn
- Advanced Photonics Research Institute (APRI), Gwangju Institute of Science and Technology (GIST), Gwangju, Republic of Korea
| | - Chang Hwan Kim
- School of Industrial Technology, Division of Mechanical Engineering Technology, Yeungnam University College, Daegu, Republic of Korea
| | - Ho Yong Park
- Department of Surgery, Kyungpook National University School of Medicine, Daegu, Republic of Korea
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9
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Theranostic Nanoseeds for Efficacious Internal Radiation Therapy of Unresectable Solid Tumors. Sci Rep 2016; 6:20614. [PMID: 26852805 PMCID: PMC4745015 DOI: 10.1038/srep20614] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 01/08/2016] [Indexed: 02/05/2023] Open
Abstract
Malignant tumors are considered “unresectable” if they are adhere to vital structures or the surgery would cause irreversible damages to the patients. Though a variety of cytotoxic drugs and radiation therapies are currently available in clinical practice to treat such tumor masses, these therapeutic modalities are always associated with substantial side effects. Here, we report an injectable nanoparticle-based internal radiation source that potentially offers more efficacious treatment of unresectable solid tumors without significant adverse side effects. Using a highly efficient incorporation procedure, palladium-103, a brachytherapy radioisotope in clinical practice, was coated to monodispersed hollow gold nanoparticles with a diameter about 120 nm, to form 103Pd@Au nanoseeds. The therapeutic efficacy of 103Pd@Au nanoseeds were assessed when intratumorally injected into a prostate cancer xenograft model. Five weeks after a single-dose treatment, a significant tumor burden reduction (>80%) was observed without noticeable side effects on the liver, spleen and other organs. Impressively, >95% nanoseeds were retained inside the tumors as monitored by Single Photon Emission Computed Tomography (SPECT) with the gamma emissions of 103Pd. These findings show that this nanoseed-based brachytherapy has the potential to provide a theranostic solution to unresectable solid tumors.
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10
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Wang X, Zhang X, Li X, Amos RA, Shaitelman SF, Hoffman K, Howell R, Salehpour M, Zhang SX, Sun TL, Smith B, Tereffe W, Perkins GH, Buchholz TA, Strom EA, Woodward WA. Accelerated partial-breast irradiation using intensity-modulated proton radiotherapy: do uncertainties outweigh potential benefits? Br J Radiol 2013; 86:20130176. [PMID: 23728947 PMCID: PMC3755395 DOI: 10.1259/bjr.20130176] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 05/22/2013] [Accepted: 05/29/2013] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE Passive scattering proton beam (PSPB) radiotherapy for accelerated partial-breast irradiation (APBI) provides superior dosimetry for APBI three-dimensional conformal photon radiotherapy (3DCRT). Here we examine the potential incremental benefit of intensity-modulated proton radiotherapy (IMPT) for APBI and compare its dosimetry with PSPB and 3DCRT. METHODS Two theoretical IMPT plans, TANGENT_PAIR and TANGENT_ENFACE, were created for 11 patients previously treated with 3DCRT APBI and were compared with PSPB and 3DCRT plans for the same CT data sets. The impact of range, motion and set-up uncertainties as well as scanned spot mismatching between fields of IMPT plans was evaluated. RESULTS IMPT plans for APBI were significantly better regarding breast skin sparing (p<0.005) and other normal tissue sparing than 3DCRT plans (p<0.01) with comparable target coverage (p=ns). IMPT plans were statistically better than PSPB plans regarding breast skin (p<0.002) and non-target breast (p<0.007) in higher dose regions but worse or comparable in lower dose regions. IMPT plans using TANGENT_ENFACE were superior to that using TANGENT_PAIR in terms of target coverage (p<0.003) and normal tissue sparing (p<0.05) in low-dose regions. IMPT uncertainties were demonstrated for multiple causes. Qualitative comparison of dose-volume histogram confidence intervals for IMPT suggests that numeric gains may be offset by IMPT uncertainties. CONCLUSION Using current clinical dosimetry, PSPB provides excellent dosimetry compared with 3DCRT with fewer uncertainties compared with IMPT. ADVANCES IN KNOWLEDGE As currently delivered in the clinic, PSPB planning for APBI provides as good or better dosimetry than IMPT with less uncertainty.
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Affiliation(s)
- X Wang
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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11
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Rosenkranz KM, Tsui E, McCabe EB, Gui J, Underhill K, Barth RJ. Increased rates of long-term complications after MammoSite brachytherapy compared with whole breast radiation therapy. J Am Coll Surg 2013; 217:497-502. [PMID: 23830216 DOI: 10.1016/j.jamcollsurg.2013.03.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Revised: 03/12/2013] [Accepted: 03/26/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Due to its short duration of therapy and low rates of local recurrence, women undergoing breast conservation are increasingly opting for partial breast irradiation with the MammoSite (Cytyc/Hologic) catheter. In early follow-up studies, few complications were reported. Few data, however, exist regarding longer-term complications. We compared the long-term local toxicities of MammoSite partial breast irradiation with those resulting from whole breast radiation. STUDY DESIGN This was a retrospective study performed in a single academic medical center. All patients who underwent breast-conserving surgery between 2003 and 2008, who met institutional criteria for brachytherapy, were included. We compared women treated with MammoSite with patients treated with whole breast radiation therapy (WBRT). Endpoints included incidence of palpable masses at the lumpectomy site, telangiectasias, and local recurrence. RESULTS Seventy-one MammoSite patients and 245 WBRT patients were well matched with regard to clinical characteristics. Median follow-up was 4 years. A palpable mass developed at the site of lumpectomy in 27% of the MammoSite patients compared with 7% of the WBRT patients (p < 0.0001). Telangiectasias developed more frequently in the MammoSite group than in the WBRT group (24% vs 4%, p < 0.001). Forty-two percent of patients treated with MammoSite developed a palpable mass, telangectasia, or both. CONCLUSIONS Palpable masses and telangiectasias are frequent long-term complications after MammoSite brachytherapy and occur at a significantly higher rate after MammoSite brachytherapy than after WBRT. This increased rate of long-term local toxicity should be considered when counseling women on options for adjuvant radiation therapy after breast-conserving surgery.
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Affiliation(s)
- Kari M Rosenkranz
- Department of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.
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12
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Breast conservation therapy utilizing partial breast brachytherapy for early-stage cancer of the breast: a retrospective review from the Saint Luke's Cancer Institute. Am J Clin Oncol 2013; 38:174-8. [PMID: 23608831 DOI: 10.1097/coc.0b013e31828f5b1f] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Accelerated partial breast irradiation (APBI) is a convenient alternative to whole-breast irradiation, as less overall time is needed for completion. The use of APBI outside the framework of large prospective clinical trials has markedly increased. To our knowledge, no high-volume, community-based breast program has published their experience with APBI. METHODS The records of 93 consecutive patients who underwent APBI utilizing Mammosite Radiation Therapy System from 2005 to 2010 at Saint Luke's Cancer Institute in Kansas City, MO, were retrospectively reviewed. The Kaplan-Meier method was used to estimate the ipsilateral breast recurrence rate and recurrence-free survival. RESULTS Median age at diagnosis was 63 years (range, 45 to 86 y) and mean follow-up was 29 months. Patient stratification ASTRO consensus classifications for APBI was 37% suitable, 57% cautionary, and 6% unsuitable. The 3-year breast control rate was 98.7%. Three-year overall recurrence-free survival was 94.4%, and 3-year mastectomy-free survival was 97.4%. Using univariate analysis, no tumor or patient factors were associated with ipsilateral breast recurrence. However, tumor grade (P<0.05), stage (P=0.04), estrogen receptor status (P<0.001), progesterone receptor status (P<0.001), tumor size (P<0.001), and ASTRO suitability criteria (P=0.027) were associated with overall recurrence-free survival. No differences were observed when outcomes of patients with ductal carcinoma in situ were compared with those with invasive disease. CONCLUSIONS In our high-volume community-based program, APBI outcomes are comparable with those reported from large academic institutions. We also found relationships between tumor stage, grade, negative estrogen receptor status, and ASTRO suitability criteria with overall recurrence rates. The continued careful application of APBI in appropriately selected patients appears warranted until phase III trials comparing this modality to whole-breast irradiation have matured.
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13
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Peng CL, Shih YH, Liang KS, Chiang PF, Yeh CH, Tang IC, Yao CJ, Lee SY, Luo TY, Shieh MJ. Development of in Situ Forming Thermosensitive Hydrogel for Radiotherapy Combined with Chemotherapy in a Mouse Model of Hepatocellular Carcinoma. Mol Pharm 2013; 10:1854-64. [DOI: 10.1021/mp3006424] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Cheng-Liang Peng
- Institute of Biomedical Engineering,
College of Medicine and College of Engineering, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei
100, Taiwan
- Isotope Application
Division, Institute of Nuclear Energy Research, P.O. Box 3-27,
Longtan, Taoyuan 325, Taiwan
| | - Ying-Hsia Shih
- Institute of Biomedical Engineering,
College of Medicine and College of Engineering, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei
100, Taiwan
- Isotope Application
Division, Institute of Nuclear Energy Research, P.O. Box 3-27,
Longtan, Taoyuan 325, Taiwan
| | - Kuo-Sheng Liang
- Institute of Biomedical Engineering,
College of Medicine and College of Engineering, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei
100, Taiwan
| | - Ping-Fang Chiang
- Isotope Application
Division, Institute of Nuclear Energy Research, P.O. Box 3-27,
Longtan, Taoyuan 325, Taiwan
| | - Chung-Hsin Yeh
- Isotope Application
Division, Institute of Nuclear Energy Research, P.O. Box 3-27,
Longtan, Taoyuan 325, Taiwan
| | - I-Chang Tang
- Isotope Application
Division, Institute of Nuclear Energy Research, P.O. Box 3-27,
Longtan, Taoyuan 325, Taiwan
| | - Cheng-Jung Yao
- Institute of Biomedical Engineering,
College of Medicine and College of Engineering, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei
100, Taiwan
| | - Shin-Yi Lee
- Institute of Biomedical Engineering,
College of Medicine and College of Engineering, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei
100, Taiwan
| | - Tsai-Yueh Luo
- Isotope Application
Division, Institute of Nuclear Energy Research, P.O. Box 3-27,
Longtan, Taoyuan 325, Taiwan
| | - Ming-Jium Shieh
- Institute of Biomedical Engineering,
College of Medicine and College of Engineering, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei
100, Taiwan
- Department of Oncology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
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Cheng CC, Lu N, Peng CL, Chang CC, Mai FD, Chen LY, Liao MH, Wang WM, Chang J. Targeting to overexpressed glucose-regulated protein 78 in gastric cancer discovered by 2D DIGE improves the diagnostic and therapeutic efficacy of micelles-mediated system. Proteomics 2012; 12:2584-97. [PMID: 22778057 DOI: 10.1002/pmic.201100602] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The survivals of gastric cancer (GC) patients are associated with early diagnosis and effective treatments. Therefore, it is urgent for the discovery of early GC biomarkers and tumor-targeting therapeutics. The aim of this study was to uncover putative tissue biomarkers of GC using 2D DIGE and then apply one of these specific markers in GC treatment. We found three putative biomarkers of GC with significant differences in expression level compared to adjacent normal tissue, including glucose-regulated protein 78 (GRP78) and glutathione s-transferase pi (GSTpi) with increased expression level, and alpha-1 antitrypsin (A1AT) with reduced expression level. The overexpressed GRP78 was used as a targeted protein for guiding the drugs to tumor cells, leading to more effective treatment for GC xenografts. Our results demonstrated that the designated GRP78-binding peptide based on the sequence, WIFPWIQL, was selectively prone to recognize and bind to GC MKN45 cells in vitro, and also improve the delivery efficiency of polymeric micelles-encapsulated drugs into tumor cells and displayed better therapeutic outcome in experimental animals. This strategy of GRP78-mediated drug targeting system may bring chemotherapeutic drugs with more precise targeting to tumor cells, leading to minimize side effects on patients after chemotherapy.
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Affiliation(s)
- Chun-Chia Cheng
- Graduate Institute of Medical Sciences, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Wilder RB, Curcio LD, Khanijou RK, Eisner ME, Kakkis JL, Chittenden L, Agustin J, Lizarde J, Mesa AV, Macedo JC, Ravera J, Tokita KM. Preliminary Results in 173 Breast Cancer Patients Treated with Post-Lumpectomy MammoSite Single-Lumen Brachytherapy or Multi-Catheter Brachytherapy. Breast J 2010; 16:581-6. [DOI: 10.1111/j.1524-4741.2010.00977.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Njeh CF, Saunders MW, Langton CM. Accelerated Partial Breast Irradiation (APBI): A review of available techniques. Radiat Oncol 2010; 5:90. [PMID: 20920346 PMCID: PMC2958971 DOI: 10.1186/1748-717x-5-90] [Citation(s) in RCA: 144] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Accepted: 10/04/2010] [Indexed: 01/08/2023] Open
Abstract
Breast conservation therapy (BCT) is the procedure of choice for the management of the early stage breast cancer. However, its utilization has not been maximized because of logistics issues associated with the protracted treatment involved with the radiation treatment. Accelerated Partial Breast Irradiation (APBI) is an approach that treats only the lumpectomy bed plus a 1-2 cm margin, rather than the whole breast. Hence because of the small volume of irradiation a higher dose can be delivered in a shorter period of time. There has been growing interest for APBI and various approaches have been developed under phase I-III clinical studies; these include multicatheter interstitial brachytherapy, balloon catheter brachytherapy, conformal external beam radiation therapy and intra-operative radiation therapy (IORT). Balloon-based brachytherapy approaches include Mammosite, Axxent electronic brachytherapy and Contura, Hybrid brachytherapy devices include SAVI and ClearPath. This paper reviews the different techniques, identifying the weaknesses and strength of each approach and proposes a direction for future research and development. It is evident that APBI will play a role in the management of a selected group of early breast cancer. However, the relative role of the different techniques is yet to be clearly identified.
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Affiliation(s)
- Christopher F Njeh
- Radiation Oncology Department, Texas Oncology Tyler, 910 East Houston Street, Tyler, Texas, USA
| | - Mark W Saunders
- Radiation Oncology Department, Texas Oncology Tyler, 910 East Houston Street, Tyler, Texas, USA
| | - Christian M Langton
- Physics, Faculty of Science and Technology, Queensland University of Technology, Brisbane, Australia
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Precise correlation between MRI and histopathology - exploring treatment margins for MRI-guided localized breast cancer therapy. Radiother Oncol 2010; 97:225-32. [PMID: 20826026 DOI: 10.1016/j.radonc.2010.07.025] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Revised: 07/04/2010] [Accepted: 07/18/2010] [Indexed: 11/22/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) is more often considered to guide, evaluate or select patients for partial breast irradiation (PBI) or minimally invasive therapy. Safe treatment margins around the MRI-visible lesion (MRI-GTV) are needed to account for surrounding subclinical occult disease. PURPOSE To precisely compare MRI findings with histopathology, and to obtain detailed knowledge about type, rate, quantity and distance of occult disease around the MRI-GTV. METHODS AND MATERIALS Patients undergoing MRI and breast-conserving therapy were prospectively included. The wide local excision specimens were subjected to detailed microscopic examination. The size of the invasive (index) tumor was compared with the MRI-GTV. The gross tumor volume (GTV) was defined as the pre-treatment visible lesion. Subclinical tumor foci were reconstructed at various distances to the MRI-GTV. RESULTS Sixty-two patients (64 breasts) were included. The mean size difference between MRI-GTV and the index tumor was 1.3mm. Subclinical disease occurred in 52% and 25% of the specimens at distances ≥10mm and ≥20mm, respectively, from the MRI-GTV. CONCLUSIONS For MRI-guided minimally invasive therapy, typical treatment margins of 10mm around the MRI-GTV may include occult disease in 52% of patients. When surgery achieves a 10mm tumor-free margin around the MRI-GTV, radiotherapy to the tumor bed may require clinical target volume margins >10mm in up to one-fourth of the patients.
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Wang X, Amos RA, Zhang X, Taddei PJ, Woodward WA, Hoffman KE, Yu TK, Tereffe W, Oh J, Perkins GH, Salehpour M, Zhang SX, Sun TL, Gillin M, Buchholz TA, Strom EA. External-beam accelerated partial breast irradiation using multiple proton beam configurations. Int J Radiat Oncol Biol Phys 2010; 80:1464-72. [PMID: 20708848 DOI: 10.1016/j.ijrobp.2010.04.052] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Revised: 04/02/2010] [Accepted: 04/06/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE To explore multiple proton beam configurations for optimizing dosimetry and minimizing uncertainties for accelerated partial breast irradiation (APBI) and to compare the dosimetry of proton with that of photon radiotherapy for treatment of the same clinical volumes. METHODS AND MATERIALS Proton treatment plans were created for 11 sequential patients treated with three-dimensional radiotherapy (3DCRT) photon APBI using passive scattering proton beams (PSPB) and were compared with clinically treated 3DCRT photon plans. Monte Carlo calculations were used to verify the accuracy of the proton dose calculation from the treatment planning system. The impact of range, motion, and setup uncertainty was evaluated with tangential vs. en face beams. RESULTS Compared with 3DCRT photons, the absolute reduction of the mean of V100 (the volume receiving 100% of prescription dose), V90, V75, V50, and V20 for normal breast using protons are 3.4%, 8.6%, 11.8%, 17.9%, and 23.6%, respectively. For breast skin, with the similar V90 as 3DCRT photons, the proton plan significantly reduced V75, V50, V30, and V10. The proton plan also significantly reduced the dose to the lung and heart. Dose distributions from Monte Carlo simulations demonstrated minimal deviation from the treatment planning system. The tangential beam configuration showed significantly less dose fluctuation in the chest wall region but was more vulnerable to respiratory motion than that for the en face beams. Worst-case analysis demonstrated the robustness of designed proton beams with range and patient setup uncertainties. CONCLUSIONS APBI using multiple proton beams spares significantly more normal tissue, including nontarget breast and breast skin, than 3DCRT using photons. It is robust, considering the range and patient setup uncertainties.
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Affiliation(s)
- Xiaochun Wang
- Department of Radiation Physics, The University of Texas, M D Anderson Cancer Center, Houston, TX 77030, USA
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Rickey DW, Sasaki D, Bews J. A quality assurance tool for high-dose-rate brachytherapy. Med Phys 2010; 37:2525-32. [DOI: 10.1118/1.3425786] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ahmed HM, DiPiro PJ, Devlin PM, Nguyen ML, Bellon JR. Mammographic Appearance Following Accelerated Partial Breast Irradiation by Using MammoSite Brachytherapy. Radiology 2010; 255:362-8. [DOI: 10.1148/radiol.10091625] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Chanda N, Kan P, Watkinson LD, Shukla R, Zambre A, Carmack TL, Engelbrecht H, Lever JR, Katti K, Fent GM, Casteel SW, Smith CJ, Miller WH, Jurisson S, Boote E, Robertson JD, Cutler C, Dobrovolskaia M, Kannan R, Katti KV. Radioactive gold nanoparticles in cancer therapy: therapeutic efficacy studies of GA-198AuNP nanoconstruct in prostate tumor–bearing mice. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2010; 6:201-9. [DOI: 10.1016/j.nano.2009.11.001] [Citation(s) in RCA: 159] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Revised: 10/18/2009] [Accepted: 11/03/2009] [Indexed: 11/24/2022]
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Bensaleh S, Bezak E. Investigation of source position uncertainties & balloon deformation in MammoSite brachytherapy on treatment effectiveness. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2010; 33:35-44. [PMID: 20300986 DOI: 10.1007/s13246-010-0008-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2009] [Accepted: 02/17/2010] [Indexed: 11/26/2022]
Abstract
The MammoSite breast high dose rate brachytherapy is used in treatment of early-stage breast cancer. The tumour bed volume is irradiated with high dose per fraction in a relatively small number of fractions. Uncertainties in the source positioning and MammoSite balloon deformation will alter the prescribed dose within the treated volume. They may also expose the normal tissues in balloon proximity to excessive dose. The purpose of this work is to explore the impact of these two uncertainties on the MammoSite dose distribution in the breast using dose volume histograms and Monte Carlo simulations. The Lyman-Kutcher and relative seriality models were employed to estimate the normal tissues complications associated with the MammoSite dose distributions. The tumour control probability was calculated using the Poisson model. This study gives low probabilities for developing heart and lung complications. The probability of complications of the skin and normal breast tissues depends on the location of the source inside the balloon and the volume receiving high dose. Incorrect source position and balloon deformation had significant effect on the prescribed dose within the treated volume. A 4 mm balloon deformation resulted in reduction of the tumour control probability by 24%. Monte Carlo calculations using EGSnrc showed that a deviation of the source by 1 mm caused approximately 7% dose reduction in the treated target volume at 1 cm from the balloon surface. In conclusion, accurate positioning of the (192)Ir source at the balloon centre and minimal balloon deformation are critical for proper dose delivery with the MammoSite brachytherapy applicator. On the basis of this study, we suggest that the MammoSite treatment protocols should allow for a balloon deformation of < or = 2 mm and a maximum source deviation of < or = 1 mm.
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Affiliation(s)
- S Bensaleh
- Department of Medical Physics, Royal Adelaide Hospital, Adelaide, Australia.
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Injectable intratumoral depot of thermally responsive polypeptide-radionuclide conjugates delays tumor progression in a mouse model. J Control Release 2010; 144:2-9. [PMID: 20117157 DOI: 10.1016/j.jconrel.2010.01.032] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Accepted: 01/25/2010] [Indexed: 11/22/2022]
Abstract
This study evaluated a biodegradable drug delivery system for local cancer radiotherapy consisting of a thermally sensitive elastin-like polypeptide (ELP) conjugated to a therapeutic radionuclide. Two ELPs (49 kDa) were synthesized using genetic engineering to test the hypothesis that injectable biopolymeric depots can retain radionuclides locally and reduce the growth of tumors. A thermally sensitive polypeptide, ELP(1), was designed to spontaneously undergo a soluble-insoluble phase transition (forming viscous microparticles) between room temperature and body temperature upon intratumoral injection, while ELP(2) was designed to remain soluble upon injection and to serve as a negative control for the effect of aggregate assembly. After intratumoral administration of radionuclide conjugates of ELPs into implanted tumor xenografts in nude mice, their retention within the tumor, spatio-temporal distribution, and therapeutic effect were quantified. The residence time of the radionuclide-ELP(1) in the tumor was significantly longer than the thermally insensitive ELP(2) conjugate. In addition, the thermal transition of ELP(1) significantly protected the conjugated radionuclide from dehalogenation, whereas the conjugated radionuclide on ELP(2) was quickly eliminated from the tumor and cleaved from the biopolymer. These attributes of the thermally sensitive ELP(1) depot improved the antitumor efficacy of iodine-131 compared to the soluble ELP(2) control. This novel injectable and biodegradable depot has the potential to control advanced-stage cancers by reducing the bulk of inoperable tumors, enabling surgical removal of de-bulked tumors, and preserving healthy tissues.
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Wilder RB, Curcio LD, Khanijou RK, Eisner ME, Kakkis JL, Chittenden L, Agustin J, Lizarde J, Mesa AV, Ravera J, Tokita KM. A Contura catheter offers dosimetric advantages over a MammoSite catheter that increase the applicability of accelerated partial breast irradiation. Brachytherapy 2009; 8:373-8. [PMID: 19736045 DOI: 10.1016/j.brachy.2009.04.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2009] [Revised: 04/17/2009] [Accepted: 04/30/2009] [Indexed: 12/24/2022]
Abstract
PURPOSE The purpose of this study was to determine whether a Contura catheter (SenoRx, Inc, Aliso Viejo, CA) can increase the applicability of accelerated partial breast irradiation. METHODS AND MATERIALS One hundred eighty-two women with early stage breast carcinomas were treated with postlumpectomy brachytherapy using a Contura multilumen catheter (n=45) or a MammoSite single-lumen catheter (Cytyc Corp, Marlborough, MA) (n=137). Hypothetical MammoSite catheter treatment plans were created for the Contura patients. Treatment planning goals were to (1) avoid a radiation "hot spot" in the skin and (2) have only a small air/fluid pocket next to the balloon. RESULTS The median followup was 16 months. Eighty-nine percent (40 of 45) of Contura plans satisfied both treatment planning goals vs. only 36% (16 of 45) of MammoSite plans (p<0.0001). A Contura catheter did not require explantation in 16% (7 of 45) of patients where balloon-to-skin spacing was only 3-6mm and 11% (5 of 45) of patients where there was an air/fluid pocket >10% of the planning target volume for plan evaluation (PTV_EVAL). A MammoSite catheter was explanted in 10% of cases where the minimum balloon-to-skin distance was <7mm and in 13% of cases where there was a large air/fluid pocket next to the balloon. Our incidence rates of acute toxicity with a Contura catheter were similar to those with a MammoSite catheter. CONCLUSIONS A Contura catheter provides important dosimetric advantages over a MammoSite catheter and does not require explantation in cases where balloon-to-skin spacing is only 3-6mm or an air/fluid pocket next to the balloon is >10% of PTV_EVAL.
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Karlsson P. Accelerated partial breast cancer irradiation (APBI)--the future breast cancer radiotherapy? Acta Oncol 2009; 48:485-6. [PMID: 19308755 DOI: 10.1080/02841860902832928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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