Limits...
A clip-based protocol for breast boost radiotherapy provides clear target visualisation and demonstrates significant volume reduction over time.

Lewis L, Cox J, Morgia M, Atyeo J, Lamoury G - J Med Radiat Sci (2015)

Bottom Line: The RT/alone cohort showed significant CTV volume reduction of 38.4% (P = 0.01) at 40 Gy.The Chemo/RT cohort had significantly reduced volumes between CT1ch: median 54 cm(3) (4-118) and CT2ch: median 16 cm(3), (2-99), (P = 0.01), but no significant volume reduction thereafter.Most seroma shrinkage occurs early, enabling CT treatment planning to take place at 7 weeks, which is within the 9 weeks recommended to limit disease recurrence.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital Sydney, New South Wales, Australia.

ABSTRACT

Introduction: The clinical target volume (CTV) for early stage breast cancer is difficult to clearly identify on planning computed tomography (CT) scans. Surgical clips inserted around the tumour bed should help to identify the CTV, particularly if the seroma has been reabsorbed, and enable tracking of CTV changes over time.

Methods: A surgical clip-based CTV delineation protocol was introduced. CTV visibility and its post-operative shrinkage pattern were assessed. The subjects were 27 early stage breast cancer patients receiving post-operative radiotherapy alone and 15 receiving post-operative chemotherapy followed by radiotherapy. The radiotherapy alone (RT/alone) group received a CT scan at median 25 days post-operatively (CT1rt) and another at 40 Gy, median 68 days (CT2rt). The chemotherapy/RT group (chemo/RT) received a CT scan at median 18 days post-operatively (CT1ch), a planning CT scan at median 126 days (CT2ch), and another at 40 Gy (CT3ch).

Results: There was no significant difference (P = 0.08) between the initial mean CTV for each cohort. The RT/alone cohort showed significant CTV volume reduction of 38.4% (P = 0.01) at 40 Gy. The Chemo/RT cohort had significantly reduced volumes between CT1ch: median 54 cm(3) (4-118) and CT2ch: median 16 cm(3), (2-99), (P = 0.01), but no significant volume reduction thereafter.

Conclusion: Surgical clips enable localisation of the post-surgical seroma for radiotherapy targeting. Most seroma shrinkage occurs early, enabling CT treatment planning to take place at 7 weeks, which is within the 9 weeks recommended to limit disease recurrence.

No MeSH data available.


Related in: MedlinePlus

Schematic illustration of the imaging process and seroma volume changes over time.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4592671&req=5

fig02: Schematic illustration of the imaging process and seroma volume changes over time.

Mentions: The pattern of CTV change is illustrated in Figure2. The first CT for each cohort (CT1rt and CT1ch) was completed at similar median time points post-surgery (25 median days RT/alone and 18 median days Chemo/RT), with all subjects scanned at less than 5.3 weeks. There was no significant difference (P = 0.08) between the initial mean CTVs for each cohort. The second CT scans (CT2rt and CT2ch) were completed at considerably different time points: median of 68 days for the RT/alone cohort and median of 126 days for the Chemo/RT cohort.


A clip-based protocol for breast boost radiotherapy provides clear target visualisation and demonstrates significant volume reduction over time.

Lewis L, Cox J, Morgia M, Atyeo J, Lamoury G - J Med Radiat Sci (2015)

Schematic illustration of the imaging process and seroma volume changes over time.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4592671&req=5

fig02: Schematic illustration of the imaging process and seroma volume changes over time.
Mentions: The pattern of CTV change is illustrated in Figure2. The first CT for each cohort (CT1rt and CT1ch) was completed at similar median time points post-surgery (25 median days RT/alone and 18 median days Chemo/RT), with all subjects scanned at less than 5.3 weeks. There was no significant difference (P = 0.08) between the initial mean CTVs for each cohort. The second CT scans (CT2rt and CT2ch) were completed at considerably different time points: median of 68 days for the RT/alone cohort and median of 126 days for the Chemo/RT cohort.

Bottom Line: The RT/alone cohort showed significant CTV volume reduction of 38.4% (P = 0.01) at 40 Gy.The Chemo/RT cohort had significantly reduced volumes between CT1ch: median 54 cm(3) (4-118) and CT2ch: median 16 cm(3), (2-99), (P = 0.01), but no significant volume reduction thereafter.Most seroma shrinkage occurs early, enabling CT treatment planning to take place at 7 weeks, which is within the 9 weeks recommended to limit disease recurrence.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital Sydney, New South Wales, Australia.

ABSTRACT

Introduction: The clinical target volume (CTV) for early stage breast cancer is difficult to clearly identify on planning computed tomography (CT) scans. Surgical clips inserted around the tumour bed should help to identify the CTV, particularly if the seroma has been reabsorbed, and enable tracking of CTV changes over time.

Methods: A surgical clip-based CTV delineation protocol was introduced. CTV visibility and its post-operative shrinkage pattern were assessed. The subjects were 27 early stage breast cancer patients receiving post-operative radiotherapy alone and 15 receiving post-operative chemotherapy followed by radiotherapy. The radiotherapy alone (RT/alone) group received a CT scan at median 25 days post-operatively (CT1rt) and another at 40 Gy, median 68 days (CT2rt). The chemotherapy/RT group (chemo/RT) received a CT scan at median 18 days post-operatively (CT1ch), a planning CT scan at median 126 days (CT2ch), and another at 40 Gy (CT3ch).

Results: There was no significant difference (P = 0.08) between the initial mean CTV for each cohort. The RT/alone cohort showed significant CTV volume reduction of 38.4% (P = 0.01) at 40 Gy. The Chemo/RT cohort had significantly reduced volumes between CT1ch: median 54 cm(3) (4-118) and CT2ch: median 16 cm(3), (2-99), (P = 0.01), but no significant volume reduction thereafter.

Conclusion: Surgical clips enable localisation of the post-surgical seroma for radiotherapy targeting. Most seroma shrinkage occurs early, enabling CT treatment planning to take place at 7 weeks, which is within the 9 weeks recommended to limit disease recurrence.

No MeSH data available.


Related in: MedlinePlus