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Preoperative single fraction partial breast radiotherapy for early-stage breast cancer.

Publication ,  Journal Article
Palta, M; Yoo, S; Adamson, JD; Prosnitz, LR; Horton, JK
Published in: Int J Radiat Oncol Biol Phys
January 1, 2012

PURPOSE: Several recent series evaluating external beam accelerated partial breast irradiation (PBI) have reported adverse cosmetic outcomes, possibly related to large volumes of normal tissue receiving near-prescription doses. We hypothesized that delivery of external beam PBI in a single fraction to the preoperative tumor volume would be feasible and result in a decreased dose to the uninvolved breast compared with institutional postoperative PBI historical controls. METHODS AND MATERIALS: A total of 17 patients with unifocal Stage T1 breast cancer were identified. Contrast-enhanced subtraction magnetic resonance images were loaded into an Eclipse treatment planning system and used to define the target volumes. A "virtual plan" was created using four photon beams in a noncoplanar beam arrangement and optimized to deliver 15 Gy to the planning target volume. RESULTS: The median breast volume was 1,713 cm(3) (range: 1,014-2,140), and the median clinical target volume was 44 cm(3) (range: 26-73). In all cases, 100% of the prescription dose covered 95% of the clinical target volume. The median conformity index was 0.86 (range: 0.70-1.12). The median percentage of the ipsilateral breast volume receiving 100% and 50% of the prescribed dose was 3.8% (range: 2.2-6.9) and 13.3% (range: 7.5-20.8) compared with 18% (range: 3-42) and 53% (range: 24-65) in the institutional historical controls treated with postoperative external beam PBI (p = .002). The median maximum skin dose was 9 Gy. The median dose to 1 and 10 cm(3) of skin was 6.7 and 4.9 Gy. The doses to the heart and ipsilateral lung were negligible. CONCLUSION: Preoperative PBI resulted in a substantial reduction in ipsilateral breast tissue dose compared with postoperative PBI. The skin dose appeared reasonable, given the small volumes. A prospective Phase I trial evaluating this technique is ongoing.

Duke Scholars

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

January 1, 2012

Volume

82

Issue

1

Start / End Page

37 / 42

Location

United States

Related Subject Headings

  • Tumor Burden
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy Dosage
  • Radiosurgery
  • Preoperative Care
  • Organs at Risk
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Magnetic Resonance Imaging
  • Humans
 

Citation

APA
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ICMJE
MLA
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Palta, M., Yoo, S., Adamson, J. D., Prosnitz, L. R., & Horton, J. K. (2012). Preoperative single fraction partial breast radiotherapy for early-stage breast cancer. Int J Radiat Oncol Biol Phys, 82(1), 37–42. https://doi.org/10.1016/j.ijrobp.2010.09.041
Palta, Manisha, Sua Yoo, Justus D. Adamson, Leonard R. Prosnitz, and Janet K. Horton. “Preoperative single fraction partial breast radiotherapy for early-stage breast cancer.Int J Radiat Oncol Biol Phys 82, no. 1 (January 1, 2012): 37–42. https://doi.org/10.1016/j.ijrobp.2010.09.041.
Palta M, Yoo S, Adamson JD, Prosnitz LR, Horton JK. Preoperative single fraction partial breast radiotherapy for early-stage breast cancer. Int J Radiat Oncol Biol Phys. 2012 Jan 1;82(1):37–42.
Palta, Manisha, et al. “Preoperative single fraction partial breast radiotherapy for early-stage breast cancer.Int J Radiat Oncol Biol Phys, vol. 82, no. 1, Jan. 2012, pp. 37–42. Pubmed, doi:10.1016/j.ijrobp.2010.09.041.
Palta M, Yoo S, Adamson JD, Prosnitz LR, Horton JK. Preoperative single fraction partial breast radiotherapy for early-stage breast cancer. Int J Radiat Oncol Biol Phys. 2012 Jan 1;82(1):37–42.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

January 1, 2012

Volume

82

Issue

1

Start / End Page

37 / 42

Location

United States

Related Subject Headings

  • Tumor Burden
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy Dosage
  • Radiosurgery
  • Preoperative Care
  • Organs at Risk
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Magnetic Resonance Imaging
  • Humans