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Kaidar-Person O, Nissen HD, Yates ES, Andersen K, Boersma LJ, Boye K, Canter R, Costa E, Daniel S, Hol S, Jensen I, Lorenzen EL, Mjaaland I, Nielsen MEK, Poortmans P, Vikström J, Webb J, Offersen BV. Postmastectomy Radiation Therapy Planning After Immediate Implant-based Reconstruction Using the European Society for Radiotherapy and Oncology-Advisory Committee in Radiation Oncology Practice Consensus Guidelines for Target Volume Delineation. Clin Oncol (R Coll Radiol) 2020; 33:20-29. [PMID: 32988717 DOI: 10.1016/j.clon.2020.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/12/2020] [Accepted: 09/10/2020] [Indexed: 10/23/2022]
Abstract
AIMS To evaluate how common radiation therapy techniques perform in the setting of the new European Society for Radiotherapy and Oncology-Advisory Committee in Radiation Oncology Practice (ESTRO-ACROP) delineation recommendations for immediate breast reconstruction (IBR). MATERIALS AND METHODS Seven Danish radiation therapy centres and six international European centres participated in this project. Two breast cancer cases (one left-sided and one right-sided) with a retropectoral implant were chosen for radiation therapy planning using deep-inspiration breath-hold. Target volumes were delineated according to ESTRO-ACROP delineation recommendations. The centres were asked to plan the cases using any radiation therapy technique according to the Danish Breast Cancer Group plan objectives. RESULTS In total, 35 treatment plans were collected. Half of the submitted plans, for both the left-sided and the right-sided case, used the field-in-field (FiF) technique (nine for each), a quarter used volumetric arc radiation therapy (VMAT; five for right-sided, four for left-sided) and the remaining quarter was a mix of inverse intensity-modulated radiation therapy (IMRT), helicoidal therapy and hybrid (combined open fields and VMAT) techniques. Mean clinical target volume doses were in the range 99-102% of the prescribed dose. The median FiF mean heart dose (MHD) for right-sided radiation therapy was 1 Gy (range 0.8-3.7) and 5.2 Gy for left-sided radiation therapy (range 2.2-6.5). For right-sided radiation therapy, the median VMAT MHD was 3.42 Gy, for IMRT was 2.3 Gy and for helicoidal therapy was 5.1 Gy. For left-sided radiation therapy, the median VMAT MHD was 6.3 Gy, for IMRT was 7.8 Gy and for helicoidal therapy was 7.3 Gy. CONCLUSIONS Different radiation therapy techniques could be used to plan radiation therapy in the setting of IBR. FiF provided good coverage with acceptable organ at risk doses. The best dose distribution results as a trade-off between the objectives of target volume coverage and high-dose organ at risk inclusion. The radiation therapy technique affects the interplay between these objectives.
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Affiliation(s)
- O Kaidar-Person
- Oncology Institute, Radiation Therapy Unit, Rambam Medical Center, Haifa, Israel; Breast Radiation Unit, Sheba Tel Ha'shomer, Ramat Gan, Israel; School for Oncology and Developmental Biology (GROW), Maastricht University Medical Centre, Maastricht, the Netherlands.
| | - H D Nissen
- Department of Oncology, Vejle Hospital, Vejle, Denmark
| | - E S Yates
- Department of Medical Physics, Aarhus University Hospital, Aarhus, Denmark
| | - K Andersen
- Department of Medical Physics, Herlev-Gentofte Hospital, Copenhagen, Denmark
| | - L J Boersma
- Department of Radiation Oncology (MAASTRO), School for Oncology and Developmental Biology (GROW), Maastricht University Medical Centre, Maastricht, the Netherlands
| | - K Boye
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
| | - R Canter
- MAASTRO Clinic, Maastricht University Hospital, Maastricht, the Netherlands
| | - E Costa
- Institut Curie, Paris, France
| | - S Daniel
- Department of Oncology, Rambam Health Care Campus, Haifa, Israel
| | - S Hol
- Instituut Verbeeten, Tilburg, the Netherlands
| | - I Jensen
- Department of Medical Physics, Aalborg University Hospital, Aalborg, Denmark
| | - E L Lorenzen
- Laboratory of Radiation Physics, Odense University Hospital, Odense, Denmark
| | - I Mjaaland
- Department of Radiation Oncology and Hematology, Stavanger University Hospital, Stavanger, Norway
| | - M E K Nielsen
- Department of Clinical Oncology, Zealand University Hospital, Roskilde, Denmark
| | - P Poortmans
- Iridium Kankernetwerk, Wilrijk-Antwerp, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk-Antwerp, Belgium
| | - J Vikström
- Department of Radiation Oncology and Hematology, Stavanger University Hospital, Stavanger, Norway
| | - J Webb
- The Christie NHS Foundation Trust, Manchester, UK
| | - B V Offersen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
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Stick L, Lorenzen E, Yates E, Anandadas C, Andersen K, Aristei C, Byrne O, Hoi S, Jensen I, Kirby A, Kirova Y, Marrazzo L, Matías-Pérez A, Nielsen M, Nissen H, Oliveros S, Verhoeven K, Vikström J, Offersen B. PV-0046 Patient selection for proton therapy of early breast cancer - the DBCG phase II study strategy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30466-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Vikström J, Sydsjö G, Hammar M, Bladh M, Josefsson A. Risk of postnatal depression or suicide after in vitro fertilisation treatment: a nationwide case-control study. BJOG 2015; 124:435-442. [PMID: 26663705 DOI: 10.1111/1471-0528.13788] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine whether women who undergo in vitro fertilisation (IVF) treatment are at greater risk of postnatal suicide or postnatal depression (PND) requiring psychiatric care, compared with women who conceive spontaneously. DESIGN Case-control study using data from national registers. SETTING Sweden during the period 2003-2009. POPULATION Cases were 3532 primiparous women who had given birth following IVF treatment. An aged-matched control group of 8553 mothers was randomly selected from the medical birth register. METHODS Logistic regression analyses were performed with PND as the outcome, and with known risk factors of PND as well as IVF/spontaneous birth as covariates. MAIN OUTCOME MEASURES Postnatal depression (PND), defined as diagnoses F32-F39 of the tenth edition of the International Classification of Diseases (ICD-10), within 12 months of childbirth. RESULTS Initial analyses showed that PND was more common in the control group than in the IVF group (0.8 versus 0.4%; P = 0.04); however, these differences disappeared when confounding factors were controlled for. A history of any psychiatric illness (P = 0.000; odds ratio, OR = 25.5; 95% confidence interval, 95% CI = 11.7-55.5), any previous affective disorder (P = 0.000; OR = 26.0; 95% CI = 10.5-64.0), or specifically a personality disorder (P = 0.028; OR = 3.8; 95% CI = 1.2-12.7) increased the risk of PND. No woman in either group committed suicide during the first year after childbirth. CONCLUSIONS Whereas mothers who receive IVF treatment are not at increased risk of PND, the risk is increased among mothers with a history of mental illness. TWEETABLE ABSTRACT A Swedish study on 3532 women showed that IVF treatment does not increase the risk of postnatal depression.
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Affiliation(s)
- J Vikström
- Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.,Department of Obstetrics and Gynaecology in Linköping, County Council of Östergötland, Linköping, Sweden
| | - G Sydsjö
- Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.,Department of Obstetrics and Gynaecology in Linköping, County Council of Östergötland, Linköping, Sweden
| | - M Hammar
- Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.,Department of Obstetrics and Gynaecology in Linköping, County Council of Östergötland, Linköping, Sweden
| | - M Bladh
- Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.,Department of Obstetrics and Gynaecology in Linköping, County Council of Östergötland, Linköping, Sweden
| | - A Josefsson
- Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.,Department of Obstetrics and Gynaecology in Linköping, County Council of Östergötland, Linköping, Sweden
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Abstract
OBJECTIVE To assess self-perceived mental health in women treated with in vitro fertilisation (IVF) 20-23 years previously, while comparing them to a reference group, and to determine any differences in mental health between those who had given birth, those who had adopted a child, those who had given birth and adopted a child and those who remained childless. DESIGN A cross-sectional study. SETTING A Center of Reproductive Medicine (RMC) at a Swedish University hospital. PARTICIPANTS 520 women who had undergone at least one IVF cycle at the University Hospital in Linköping between 1986 and 1989. 504 of 520 women (97%) were eligible for follow-up. While 34 women declined, 93 per cent (n=470) of the women agreed to participate. The reference group consisted of 150 women of the Swedish population included in a study that was used to validate the Symptom CheckList (SCL)-90. INTERVENTIONS Follow-up was conducted in 2008-2009. The SCL-90 was used to measure the women's self-perceived mental health and a questionnaire specific for this study was used to retain demographic information. OUTCOME MEASURES The SCL-90 assesses 9 primary dimensions; somatisation, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism. There is also a global index of distress. RESULTS Women who had previously undergone IVF treatment were at increased risk of symptoms of depression (p=0.017), obsessive-compulsion (p=0.02) and somatisation (p≤0.001) when compared to a reference group. In addition, the women who have remained childless are at increased risk of symptoms of depression (p=0.009) and phobic anxiety (p=0.017). CONCLUSIONS The majority of the women who have been treated with IVF 20-23 years previously appear to be in good mental health. However, women who remain childless and/or without partner after unsuccessful infertility treatment constitute a vulnerable group even later on in life.
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Affiliation(s)
- J Vikström
- Faculty of Health Sciences, Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
- Department of Obstetrics and Gynecology in Linköping, County Council of Östergötland, Linköping, Sweden
| | - A Josefsson
- Faculty of Health Sciences, Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - M Bladh
- Faculty of Health Sciences, Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
- Department of Obstetrics and Gynecology in Linköping, County Council of Östergötland, Linköping, Sweden
| | - G Sydsjö
- Faculty of Health Sciences, Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
- Department of Obstetrics and Gynecology in Linköping, County Council of Östergötland, Linköping, Sweden
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Dybvik K, Hjelstuen M, Mjaaland I, Iversen K, Vikström J. 1216 poster PATIENT SELECTION CRITERIA FOR RADIOTHERAPY OF LEFT-SIDED BREAST CANCER WITH RESPIRATORY GATING. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71338-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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