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1.
Purpose
The brain remains an uncommon site of colorectal cancer metastases. Due to the improvement of overall colorectal cancer patient survival, the incidence of brain metastases will likely rise. We report the efficacy and safety of hypofractionnated stereotactic radiation therapy and stereotactic radiosurgery, and its role in colorectal cancer brain metastasis management.Methods and material
Between June 2010 and December 2014, fifteen consecutive patients received hypofractionnated stereotactic radiation therapy or stereotactic radiosurgery as first local therapy or following surgical removal for colorectal cancer brain metastases. The primary endpoint was overall survival. Secondary endpoints were brain progression free survival, in field control rates and safety.Results
Median follow-up was 41 months (95% confidence interval [CI]: [8.9–73.1 months]), median overall survival was 8 months (95% CI [4.7–11.3 months]), and median brain progression-free survival was 5 months (95% CI [3.9–6.1 months]). Five in field recurrences were observed, which makes a control rate per metastases at 6 and 12 months of 77.8% (95% CI [74.34%–81.26%]), 51.9% (95% CI [44.21%–59.59%]) respectively. Over the 19 treatment sequences, five in field recurences were observed: 6, 12 and 18 months control rate per treatment sequence were 93.3% (95% CI [90.42%–96.18%]), 68.1% (95% CI [62.03%–74.17%]) and 45.4% (95% CI [36.14%–54.66%]) respectively. Immediate tolerance was good with no toxicity grade III or more. Long-term toxicity included two radionecrosis among which, one was symptomatic.Discussion
The results of this retrospective analysis suggest that hypofractionnated stereotactic radiation therapy and stereotactic radiosurgery are effective and safe treatment modalities for single and multiple small brain metastases from colorectal cancer. However, results need to be confirmed by multicenter, collected data. 相似文献2.
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L. Ghorbal F. Elloumi W. Siala A. Khabir A. Ghorbel M. Frikha J. Daoud 《Cancer radiothérapie》2017,21(1):40-44
Purpose
Retrospective analysis of clinical aspects and therapeutic results of nasopharynx cancer local failures.Patients and methods
Forty patients with local failure with or without nodal involvement of nasopharyngeal carcinoma were treated between 1993 and 2013. Reirradiation of nasopharynx was delivered at the dose of 60 Gy. Platinum-based chemotherapy was indicated in case of locally advanced disease and/or associated nodal failure.Results
The mean age at diagnosis of primitive tumour was 41.9 years (26–67 years). The mean time of relapse occurrence was 31.7 months (6–104 months). Sixty five percent of failures were confined to the nasopharynx. Nodal failure was seen in 14 cases. Twenty-eight patients had chemotherapy. Twenty-five patients had reirradiation of nasopharynx. Mean follow-up was 98 months (12–191 months). Fourteen patients were still alive and in complete remission. Five-year survival was 40.7%. Xerostomia was the most frequent late toxicity. No haemorrhage was seen.Conclusion
Reirradiation is the mainstay treatment of nasopharyngeal local failure. Late toxicity seems to decrease with novel techniques of reirradiation. 相似文献5.
Z. Ajgal S. de Percin V. Diéras J.Y. Pierga F. Campana A. Fourquet Y.M. Kirova 《Cancer radiothérapie》2017,21(2):114-118
Background and purposes
We evaluate the early toxicity of concurrent use of radiotherapy, pertuzumab and trastuzumab in patients with HER2-positive metastatic or locally recurrent unresectable breast cancer.Patients and methods
A retrospective study was performed in a population of 23 consecutive patients between 2013 and 2015. Radiotherapy was performed on the chest area or metastatic sites during maintenance with pertuzumab and trastuzumab after six cycles of pertuzumab, trastuzumab and docetaxel. Toxicity was assessed according to the National Cancer Institute Common Toxicity Criteria version 4.Results
Irradiation volumes were whole breast (8 patients) and chest wall (9 patients) at 50 Gy in 25 fractions, the supraclavicular nodes (16 patients), the axillary area (nine patients) and the internal mammary nodes (9 patients) at 46 Gy in 23 fractions. For five patients, radiotherapy was palliative: bone irradiation (4 patients), whole brain radiotherapy (one patient). Median follow-up was 12.6 months (range: 6.1–21.6 months) since the start of pertuzumab and trastuzumab. One patient presented an asymptomatic decrease of left ventricular ejection fraction below 50%. No symptomatic cardiac events were reported. Two patients presented asymptomatic grade I radiation pneumonitis. Acute skin toxicity was grade III (one patient), grade II (6 patients), and grade I (5 patients). There were two grade II esophagitis.Conclusion
Combination of pertuzumab, trastuzumab and radiotherapy was well tolerated, which should be confirmed by the results of larger studies. 相似文献6.
Purpose
Radiotherapy plays a major role in relieving pain caused by bone metastases; paradoxically initial flare of symptom is common. Our objectives were to assess prospectively the incidence, and to identify predictor's factors of this acute complication.Patient and methods
Forty-one patients treated with analgesic external beam radiotherapy were followed prospectively. Patients recorded pain severity and analgesic intake was documented. Pain flare was defined as an increase of two points in the intensity of pain on the numerical scale with no reduction in analgesic intake and/or 25% increase of the analgesic intake without decreasing pain intensity.Results
Primary cancer was the breast, lung and prostate in 49%, 29% and 22% of patients respectively. Twelve patients (29%) had a pain flare. No factor was significantly associated with the occurrence of this complication. A favorable analgesic response was observed in 27 patients. The pain flare was not related to subsequent analgesic response.Conclusion
Radiotherapy is an effective treatment of pain related to bone metastasis, but with a high incidence of painful exacerbation. 相似文献7.
H. Carette J.-C. Faivre J. Salleron A.-S. Baumann L. Uwer C. Clément-Duchêne J.-M. Vignaud I. Petit J. Siat A. Tiotiu V. Beckendorf 《Cancer radiothérapie》2017,21(8):774-783
Purpose
Prophylactic radiotherapy to prevent procedure-tracts metastases from malignant pleural mesothelioma remains controversial and clinical practice varies. The purpose was to assess the efficacy of local radiotherapy in a single fraction of 10 Gy in preventing malignant seeding at intervention pleural site in patients with malignant pleural mesothelioma.Material and methods
This is a retrospective cohort study, including patients with histological confirmed malignant pleural mesothelioma treated by prophylactic irradiation to prevent interventional site metastases with a unique fraction of 10 Gy with 6 to 18 MeV, from January 1990 to December 2013 in the institut de cancérologie de Lorraine (Nancy, France).Results
Ninety-one patients were treated by irradiation in intervention site, involving 120 intervention pleural sites, 91 thoracoscopies, 17 thoracotomies with chest drain and 12 CT or ultrasound guided needle biopsies. The median follow-up was 7 months (interquartile between 3 and 15 months). The overall survival was 43.5% at 12 months. The local progression free survival was 43.7% at 12 month. The incidence of local recurrence was 8% at 12 months. The median interval from radiotherapy to local recurrence was 4 months (2; 32). No grade II or higher toxicity was observed.Conclusion
Irradiation of pleural intervention sites with a single fraction of 10 Gy is effective, well tolerated, simple, fast and cost effective. 相似文献8.
T. Ohnleiter P. Truntzer D. Antoni S. Guihard A.-M. Elgard G. Noël 《Cancer radiothérapie》2017,21(4):316-338
Purpose
To specify the effectiveness of head and neck cancer reirradiation and make a synthesis of prognostic factors established by published series of patients.Materials and methods
Original series of external reirradiation of head and neck cancer with at least ten patients were sought in Medline database.Results
Exclusive reirradiation with or without concurrent chemotherapy offers 11 months of median overall survival, versus 6 months for chemotherapy alone, and 20 to 40% of the patients are still alive two years after treatment. Postoperative reirradiation allows 3 years overall survival from 40 to 60%. However, side effects of grade 3 or more arise in more than half of patients. Patient-related good prognostic factors are male, young age, good performance status without comorbidities. Those related to the disease are low rT and rN stage, poor differentiation, other than squamous cell carcinomas and a nasopharyngeal, oropharyngeal or laryngeal location. Concerning the treatment, surgical resection, a dose higher than 50 to 60 Gy in a smaller-irradiated volume, an interval between the two treatments of more than 2 years and the use of an innovating technology are the most commonly highlighted prognostic factors. Concurrent chemotherapy is often associated with higher toxicity rates, without improving overall survival, unless using cisplatin for selected patients.Conclusions
Head and neck cancer reirradiation achieves long-term survival outcomes. However, regarding to its associated side effects, patients need to be carefully selected based on prognostic factors. 相似文献9.
T. Felefly R. Mazeron A. Huertas C.H. Canova P. Maroun M. Kordahi P. Morice É. Deutsch C. Haie-Méder C. Chargari 《Cancer radiothérapie》2017,21(2):109-113
Purpose
Conflicting results concerning the toxicity of radiotherapy in the setting of rheumatoid arthritis were reported in literature. This work describes the toxicity profiles of patients with rheumatoid arthritis undergoing pelvic radiotherapy for gynecologic malignancies at our institution.Patients and methods
Charts of patients with rheumatoid arthritis who underwent pelvic radiotherapy for cervical or endometrial cancer in a curative intent at the Gustave-Roussy Cancer Campus between 1990 and 2015 were reviewed for treatment-related toxicities. Acute and late effects were graded as per the Common Terminology Criteria for Adverse Events version 4.0 scoring system.Results
Eight patients with cervical cancer and three with endometrial cancer were identified. Median follow-up was 56 months. Median external beam radiotherapy dose was 45 Gy. All patients received a brachytherapy boost using either pulse- or low-dose rate technique. Concomitant chemotherapy was used in seven cases. Median time from rheumatoid arthritis diagnosis to external beam radiation therapy was 5 years. No severe acute gastrointestinal or genitourinary toxicity was reported. One patient had grade 3 dermatitis. Any late toxicity occurred in 7 /11 patients, and one patient experienced severe late toxicities. One patient with overt systemic rheumatoid arthritis symptoms at the time of external beam radiation therapy experienced late grade 3 ureteral stenosis, enterocolitis and lumbar myelitis.Conclusion
Pelvic radiotherapy, in the setting of rheumatoid arthritis, appears to be feasible, with potentially slight increase in low grade late events compared to other anatomic sites. Patients with overt systemic rheumatoid arthritis manifestation at the time of radiotherapy might be at risk of potential severe toxicities. 相似文献10.
Purpose
After stereotactic radiation therapy for brain metastases, one of the complications is radionecrosis. Differential diagnosis with tumour recurrence can be helped by different methods of imaging, although histology remains the gold standard. According to the treatment centres, practice diverges. The objective of this single-centre retrospective study was to define the power of MRI, PET scan and NMR spectroscopy to establish a decision tree.Material and methods
This study included patients who underwent stereotactic radiation therapy for brain metastases, and required, during follow-up, both a PET scan and NMR spectroscopy in order to differentiate a radiation necrosis and tumour recurrence. From 2010 to 2015, 25 patients were consistent with these criteria.Results
Conventional MRI technique, with the T1/T2 mismatch criterion, had a specificity of 75% and a sensitivity of only 44%. A lesion quotient greater than 0.3 diagnosed a recurrence with a sensitivity of 92%. PET scan combined the best sensitivity and specificity, respectively of 92% and 69%. Whatever the thresholds used in NMR spectroscopy for choline/N-acetylaspartate and choline/creatin ratios, the power of this imaging modality did not exceed that of PET scan.Conclusion
The criteria described in conventional MRI cannot by themselves establish the differential diagnosis. In first intention in case of doubt, PET scan should be done, combining the best sensitivity and specificity, whereas NMR spectroscopy used in combination does not improve these factors. 相似文献11.
B. Vandendorpe P. Guilbert C. Champagne T. Antoni T.D. Nguyen N. Gaillot-Petit S. Servagi Vernat 《Cancer radiothérapie》2017,21(8):741-748
Purpose
To evaluate the dosimetric contribution of helical tomotherapy for breast cancers compared with conformal radiotherapy in mono-isocentric technique.Patients and method
For 23 patients, the dosimetric results in mono-isocentric 3D conformational radiotherapy did not satisfy the constraints either of target volumes nor organs at risk. A prospective dosimetric comparison between mono-isocentric 3D conformational radiotherapy and helical tomotherapy was therefore carried out.Results
The use of helical tomotherapy showed a benefit in these 23 patients, with either an improvement in the conformity index or homogeneity, but with an increase in low doses. Of the 23 patients, two had pectus excavatum, five had past thoracic irradiation and two required bilateral irradiation. The other 14 patients had a combination of morphology and/or indication of lymph node irradiation. For these patients, helical tomotherapy was therefore preferred to mono-isocentric 3D conformational radiotherapy.Conclusions
Tomotherapy appears to provide better homogeneity and tumour coverage. This technique of irradiation may be justified in the case of morphological situations such as pectus exavatum and in complex clinical situations. In other cases, conformal radiotherapy in mono-isocentric technique remains to be favoured. 相似文献12.
C. Benhaïm G. Loos J.L. Achard L. Berger C. Caillé T. Frédéric-Moreau J. Biau M. Lapeyre 《Cancer radiothérapie》2017,21(1):28-33
Purpose
Intensity modulated radiotherapy for prostate cancer involves daily monitoring of the positioning of the prostate, possible with cone beam CT (CBCT). It allows increased accuracy compared to readjustments but induces an increase in the time dedicated to these medical checks. The aim of the study was to evaluate the possibility of delegation of this task to the radiation therapists by comparing their readjustments to the doctors.Patients and methods
Five consecutive patients treated with radiation for prostate cancer (76 Gy) were analysed. All had a daily CBCT for position control. The movements of the prostate relative to the bony part, the positional variations of the prostate measured by the radiation therapists and the doctors and medical time required to analyse imagery (filling of the rectum and bladder and perform a recalibration) were measured.Results
One hundred seventy-six CBCT were analysed or 980 steps in the three axes. The movements of the prostate relative to bony part were respectively at least 5 mm in 19%, 7% and 3% in the anterior–posterior, upper–lower and right–left axes. Changes readjustments between radiation therapists and doctors were in 95% of cases at the most 4 mm in the anterior–posterior and upper–lower axis, and 3 mm in the left–right axis. The time for medical use of the CBCT averaged 8 min 40 [4 to 22 min].Conclusion
The daily readjustment on the prostate using CBCT may be delegated to radiation therapists with acceptable concordance of less than 4 mm for 95% of measurements. An initial and ongoing training will ensure treatment safety. 相似文献13.
A. Keller M. Doré D. Antoni I. Menoux F. Thillays J.B. Clavier G. Delpon D. Jarnet C. Bourrier F. Lefebvre S. Chibbaro I. Darié F. Proust G. Noël 《Cancer radiothérapie》2017,21(5):377-388
Purpose
To investigate the factors that potentially lead to brain radionecrosis after hypofractionated stereotactic radiotherapy targeting the postoperative resection cavity of brain metastases.Methods and materials
A retrospective analysis conducted in two French centres, was performed in patients treated with trifractionated stereotactic radiotherapy (3 × 7.7 Gy prescribed to the 70% isodose line) for resected brain metastases. Patients with previous whole-brain irradiation were excluded of the analysis. Radionecrosis was diagnosed according to a combination of criteria including clinical, serial imaging or, in some cases, histology. Univariate and multivariate analyses were performed to determine the predictive factors of radionecrosis including clinical and dosimetric variables such as volume of brain receiving a specific dose (V8 Gy–V22 Gy).Results
One hundred eighty-one patients, with a total of 189 cavities were treated between March 2008 and February 2015. Thirty-five patients (18.5%) developed radionecrosis after a median follow-up of 15 months (range: 3–38 months) after hypofractionated stereotactic radiotherapy. One third of patients with radionecrosis were symptomatic. Multivariate analysis showed that infra-tentorial location was predictive of radionecrosis (hazard ratio [HR]: 2.97; 95% confidence interval [95% CI]: 1.47–6.01; P = 0.0025). None V8 Gy–V22 Gy was associated with appearance of radionecrosis, even if V14 Gy trended toward significance (P = 0.059).Conclusion
Analysis of patients and treatment variables revealed that infratentorial location of brain metastases was predictive for radionecrosis after hypofractionated stereotactic radiotherapy for postoperative resection cavities. 相似文献14.
C. Demoor-Goldschmidt S. Chiavassa S. Josset M.-A. Mahé S. Supiot 《Cancer radiothérapie》2017,21(2):124-129
Purpose
Bilateral pulmonary radiotherapy in children and young adults aims to reduce the recurrence of lung metastases. The radiation field includes liver tissue, which is sensitive to even low radiation doses. We investigated the feasibility of respiratory gating radiotherapy using voluntary deep inspiration breath hold and its toxicity in these patients.Patients and method
A retrospective clinical review was conducted for all patients who had undergone bilateral pulmonary radiotherapy, with or without deep inspiration breath hold, treated in our institution between October 1999 and May 2012. A dosimetric study was conducted on seven consecutive children using 4D-scan data on free-breathing and a SpiroDyn’RX-system-scan on deep inspiration breath hold. A radiation treatment of 20 Gy was simulated.Results
Concerning the clinical study, seven patients of mean age 11.9 years (range: 4.9–21.1 years) were treated with free-breathing and ten patients of mean age 15.6 years (range: 8.6–19.7 years) were treated with deep inspiration breath hold for mainly Ewing sarcoma and nephroblastoma. Within six months of radiotherapy, all patients experienced mild liver toxicity (grade 1 or 2 altered levels of alanine/aspartate aminotransferase [n = 8 of 9] or cholestasis [n = 1 of 9]), which resolved completely with no difference between deep inspiration breath hold and free-breathing technique. Over a median follow-up of 2.6 years (range: 0.1–9.3 years), four patients died from disease progression (mean 1.5 years post-radiotherapy [range: 1.1–1.6 years]) and three experienced grade III–V lung toxicity. Concerning the dosimetric study, the irradiated liver volume was significantly lower with deep inspiration breath hold than free-breathing, for each isodose (V5: 73.80% versus 86.74%, P < 0.05; V20: 5.70% versus 26.44%, P < 0.05).Conclusions
The dosimetric data of respiratory-gated bilateral pulmonary radiotherapy showed a significantly spare of normal liver tissue. Clinical data showed that this technique is feasible even in young children. However, no liver toxicity difference between deep inspiration breath hold and free-breathing was shown. 相似文献15.
C. Bednarek T.V.F. Nguyen M. Puyraveau É. Bonnet N. Lescut C. Azélie J. Miny O. Mauvais T. Maurina F. Tochet J.-F. Bosset J. Thariat X.S. Sun 《Cancer radiothérapie》2017,21(1):21-27
Purpose
To report on patterns of relapse following implementation of intensity-modulated radiotherapy and subsequent changes in practice in a tertiary care centre.Patients and methods
Between 2008 and 2011, 188 consecutive patients (mean age 59 years old) received intensity-modulated radiotherapies with curative intent for squamous cell carcinomas of the oral cavity (17.5%), oropharynx (43%), hypopharynx (21%), larynx (14%), sinonasal cavities (6%), nasopharynx (1.5%) at the university hospital of Besançon. There were stage I and II 9%, III 24.5%, IV 66.5%. One hundred and thirty-eight underwent exclusive intensity-modulated radiotherapy, 50 underwent postoperative intensity-modulated radiotherapy, 174 had concurrent chemotherapy, 57 had induction chemotherapy. Dynamic intensity-modulated radiotherapy with static fields was performed for all patients using sequential irradiation in 174 patients and simultaneous integrated boost irradiation in 14 patients.Results
With a median follow-up was 27.5 months, there was 79% of locoregional failures occurred in the 95% isodose. Two-year overall survival, disease-free, local failure-free and locoregional failure-free survival rates were73%, 60%, 79% and 72%, respectively. Prognostic factors for disease-free survival were stage (IV vs. I–III) with a relative risk of 1.7 [1.1–2.8] (P = 0.02) and T stage with 1.6 [1.04–2.5] (P = 0.03).Conclusion
The current series showed similar patterns of failure as in other tertiary care centres. We did not identify intensity-modulated radiotherapy specific relapse risks. 相似文献16.
P. Royer J. Salleron G. Vogin L. Taillandier C. Clément-Duchêne O. Klein J.-C. Faivre D. Peiffert V. Bernier 《Cancer radiothérapie》2017,21(8):731-740
Purpose
To study overall survival, risk of neurological death, local recurrence and development of new brain metastasis in patients treated for brain oligometastases with hypofractionated stereotactic radiotherapy with CyberKnife®, according to the association or not with an additional whole brain irradiation.Patients and methods
Institutional retrospective study of 102 patients treated for one to three brain metastasis: 76 with exclusive hypofractionated stereotactic radiotherapy and 26 with hypofractionated stereotactic radiotherapy and whole brain irradiation. Objectives were assessed and compared between these two groups according to the Kaplan–Meier method and Cox model.Results
Median follow-up was 18.8 months. There were no difference between exclusive hypofractionated stereotactic radiotherapy and hypofractionated stereotactic radiotherapy with whole brain irradiation for overall survival (respective median 21.5 and 20.1 months), risk of neurological death (respectively 9.2% and 15.4% at one year). At one year: the risk of cerebral progressive disease was greater in the group receiving exclusive hypofractionated stereotactic radiotherapy (respectively 43.4% vs. 26.2%, P = 0.043), the risk of local recurrence was 25% versus 17.6% (P = 0.28) and the development of new brain metastasis was 23.7% versus 11.5% (P = 0.27). After salvage treatments, crude local control was similar in the two groups, respectively 78.6% and 73.5%. Whole brain irradiation has been avoided for 72.4% of patients in the group receving exclusive hypofractionated stereotactic radiotherapy.Conclusion
Whole brain irradiation improves local control of brain metastatic disease in addition to hypofractionated stereotactic radiotherapy. Sparing whole brain irradiation for salvage treatments only does not affect overall survival or risk of neurological death in selected patients with favourable prognosis. 相似文献17.
P. Moreno-Acosta A. Vallard M. Molano A. Huertas Ó. Gamboa M. Cotes A. Romero-Rojas C. Rancoule N. Magné 《Cancer radiothérapie》2017,21(2):104-108
Purpose
Although the large impact of Human papilloma virus (HPV) in cervical cancer is established, its place as a therapeutic target is new and according to the growing literature, could be promising. In the present study, radiosensitivity's difference based on HPV-16 variants is assessed.Patients and methods
Variants of Human papilloma virus were identified before the exclusive radiotherapy in patients with cervical cancer. Data were prospectively collected. Fifty-nine patients were screened.Results
Among the 59 screened patients, 34 (57.6%) were identified to be HPV-16 (+), with 13 European and two non-European variants. Of the 34 patients, 15 experienced exclusive radiotherapy. Among them, eight had complete response (seven with European and one with non-European variants), four with European variant had partial response, three with European variant had tumour persistence and one with non-European variant progressed at 3 months.Conclusion
No radiosensitivity difference was established, probably because of the limited population. Non-European variant aggressiveness might be suggested in accordance with the literature, as it was associated with the only tumour progression. Exclusive radiotherapy provides a unique and “pure” model of radioresistance in cervical cancer and could be the missing link between in vitro studies and state of the art chemoradiotherapy studies that probably feature too many parameters to identify radioresistance causes. The present study was a first step, with the future prospects of building a larger cohort study in order to better understand HPV-induced radioresistance and then to be able to propose new made-to-measure treatments. 相似文献18.
Christian Bäumer Benjamin Ackermann Martin Hillbrand Franz-Joachim Kaiser Benjamin Koska Harald Latzel Armin Lühr Stefan Menkel Beate Timmermann 《Zeitschrift für medizinische Physik》2017,27(2):80-85
Aim
To verify the consistency of dose and range measurement in an interinstitution comparison among proton therapy institutions in Germany which use the pencil-beam scanning technique.Methods
Following a peer-to-peer approach absorbed dose and range have been intercompared in several missions at two hosting centers with two or three visiting physics teams of participating institutions using their own dosimetry equipment. A meta-analysis has been performed integrating the results of the individual missions. Dose has been determined with ionization chambers according to the dosimetry protocol IAEA TRS-398. For determination of the depth of the distal 80% dose the teams used either a scanning water phantom, a variable water column or a multi-layer ionization chamber.Results
The systematic deviation between measured doses of the participating institutions is less than 1%. Ranges differ systematically less than 0.4 mm.Conclusions
The match of measured dose and range is better than expected from the respective uncertainties. As all physics teams agree on the assessment of absorbed dose and range, an important prerequisite for a start of joint clinical studies is fulfilled. 相似文献19.
Purpose
To test if active breath control during cone-beam computed tomography (CBCT) could improve planning target volume during accelerated partial breast radiotherapy for breast cancer.Methods
Patients who were more than 40 years old, underwent breast-conserving dissection and planned for accelerated partial breast irradiation, and with postoperative staging limited to T1-2 N0 M0, or postoperative staging T2 lesion no larger than 3 cm with a negative surgical margin greater than 2 mm were enrolled. Patients with lobular carcinoma or extensive ductal carcinoma in situ were excluded. CBCT images were obtained pre-correction, post-correction and post-treatment. Set-up errors were recorded at left-right, anterior-posterior and superior-inferior directions. The differences between these CBCT images, as well as calculated radiation doses, were compared between patients with active breath control or free breathing.Results
Forty patients were enrolled, among them 25 had active breath control. A total of 836 CBCT images were obtained for analysis. CBCT significantly reduced planning target volume. However, active breath control did not show significant benefit in decreasing planning target volume margin and the doses of organ-at-risk when compared to free breathing.Conclusion
CBCT, but not active breath control, could reduce planning target volume during accelerated partial breast irradiation. 相似文献20.
M. Orré T. Piéchaud P. Sargos P. Richaud G. Roubaud L. Thomas 《Cancer radiothérapie》2017,21(2):119-123