scholarly journals Assessment of Fetal Dose and Health Effect to the Fetus from Breast Cancer Radiotherapy during Pregnancy

Life ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 84
Author(s):  
Pattarakan Suwanbut ◽  
Thiansin Liamsuwan ◽  
Danupon Nantajit ◽  
Wilai Masa-nga ◽  
Chirapha Tannanonta
Keyword(s):  
Breast Cancer ◽  
Background Radiation ◽  
Early Stage ◽  
Health Effect ◽  
Conformal Radiotherapy ◽  
First Trimester ◽  
Heavy Ion ◽  
Cancer Radiotherapy ◽  
Breast Cancer Radiotherapy ◽  
Fetal Dose

Decision for radiotherapy during the first trimester of pregnancy may occur, as patients may not realize their pregnancy at the very early stage. Since radiation dose can affect fetal development, the aim of this study was to evaluate fetal dose and associated deterministic effects and risks to the fetus from breast cancer radiotherapy of an 8-week pregnant patient. PHITS (Particle and Heavy Ion Transport code System) Monte Carlo simulation and the J-45 computational pregnancy phantom were used to simulate breast cancer radiotherapy from a 6 MV TrueBeam linear accelerator using the three dimensional-conformal radiotherapy (3D-CRT) technique with a prescribed dose to the planning target volume (PTV) of 50 Gy. Once the fetal dose was evaluated, the occurrence of the deterministic effects and risks for developing stochastic effects in the fetus were assessed using the recommendations of NCRP Report No. 174, AAPM Report No. 50, and ICRP Publication 84. The fetal dose was evaluated to be 3.37 ± 2.66 mGy, suggesting that the fetus was expected to have no additional deterministic effects, while the risks for developing cancer and malfunctions were similar to that expected from exposure to background radiation. The comparison with the other studies showed that accurate consideration of fetal position and size was important for dose determination in the fetus, especially at the early pregnancy stage when the fetus is very small.

Early-Stage Breast Cancer Radiotherapy

Breast Cancer ◽  
2018 ◽  
pp. 445-462
Author(s):  
Kamuran Arslan Ibis ◽  
Makbule Tambas ◽  
Seden Kucucuk
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Cancer Radiotherapy ◽  
Breast Cancer Radiotherapy

Fetal Dose Evaluation During Breast Cancer Radiotherapy

1998 ◽  
Vol 40 (4) ◽  
pp. 995-999 ◽  
Author(s):  
Christos Antypas ◽  
Panagiotis Sandilos ◽  
John Kouvaris ◽  
Ersi Balafouta ◽  
Eleftheria Karinou ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Radiotherapy ◽  
Dose Evaluation ◽  
Breast Cancer Radiotherapy ◽  
Fetal Dose

scholarly journals Advances in Breast Cancer Radiotherapy: Implications for Current and Future Practice

2021 ◽  
Author(s):  
Chirag Shah ◽  
Zahraa Al-Hilli ◽  
Frank Vicini
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Standard Of Care ◽  
Early Stage Breast Cancer ◽  
Partial Breast Irradiation ◽  
Breast Irradiation ◽  
Duration Of Treatment ◽  
Regional Lymph Nodes ◽  
Cancer Radiotherapy ◽  
Breast Cancer Radiotherapy

Radiation therapy (RT) is an essential component in the management of breast cancer. Following breast-conserving surgery (BCS), adjuvant RT is the standard of care for most patients. Traditionally, RT was delivered with standard whole breast irradiation (WBI) over 5-7 weeks following BCS. However, WBI regimens have evolved; hypofractionated WBI now represents the standard approach, reducing the duration of treatment to 3-4 weeks. Over the past year, five-fraction WBI regimens have also emerged as standard of care for some patients based on data from the FAST and FAST-Forward trials. An alternative to WBI that is also available for patients with early-stage breast cancer following BCS is partial breast irradiation, which can reduce the duration of treatment and the volume of breast tissue irradiated. Outcomes from multiple randomized trials with over a 10-year follow-up have demonstrated the safety and efficacy of partial breast irradiation approaches. Single-fraction intraoperative RT has also been evaluated in two prospective trials although the outcomes available, as well as current guidelines, do not support its utilization outside of prospective studies. For patients requiring RT to the regional lymph nodes, data have demonstrated the safety of hypofractionated approaches for those undergoing BCS or mastectomy without reconstruction. Future directions for early-stage breast cancer radiotherapy include the study of even shorter regimens and studies evaluating the omission of RT versus omission of endocrine therapy for favorable-risk patients. Furthermore, studies are also underway evaluating shorter courses of radiation in patients undergoing breast reconstruction and the use of tumor genomics to identify appropriate patients for omission of radiation with limited nodal involvement.

scholarly journals Deep-inspirational breath-hold (DIBH) technique in left-sided breast cancer: various aspects of clinical utility

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Szilvia Gaál ◽  
Zsuzsanna Kahán ◽  
Viktor Paczona ◽  
Renáta Kószó ◽  
Rita Drencsényi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Clinical Utility ◽  
Prospective Trial ◽  
Conformal Radiotherapy ◽  
Free Breathing ◽  
Left Breast ◽  
Breath Hold ◽  
Ipsilateral Lung ◽  
Breast Cancer Radiotherapy

Abstract Background Studying the clinical utility of deep-inspirational breath-hold (DIBH) in left breast cancer radiotherapy (RT) was aimed at focusing on dosimetry and feasibility aspects. Methods In this prospective trial all enrolled patients went through planning CT in supine position under both DIBH and free breathing (FB); in whole breast irradiation (WBI) cases prone CT was also taken. In 3-dimensional conformal radiotherapy (3DCRT) plans heart, left anterior descending coronary artery (LAD), ipsilateral lung and contralateral breast doses were analyzed. The acceptance of DIBH technique as reported by the patients and the staff was analyzed; post-RT side-effects including radiation lung changes (visual scores and lung density measurements) were collected. Results Among 130 enrolled patients 26 were not suitable for the technique while in 16, heart or LAD dose constraints were not met in the DIBH plans. Among 54 and 34 patients receiving WBI and postmastectomy/nodal RT, respectively with DIBH, mean heart dose (MHD) was reduced to < 50%, the heart V25 Gy to < 20%, the LAD mean dose to < 40% and the LAD maximum dose to about 50% as compared to that under FB; the magnitude of benefit was related to the relative increase of the ipsilateral lung volume at DIBH. Nevertheless, heart and LAD dose differences (DIBH vs. FB) individually varied. Among the WBI cases at least one heart/LAD dose parameter was more favorable in the prone or in the supine FB plan in 15 and 4 cases, respectively; differences were numerically small. All DIBH patients completed the RT, inter-fraction repositioning accuracy and radiation side-effects were similar to that of other breast RT techniques. Both the patients and radiographers were satisfied with the technique. Conclusions DIBH is an excellent heart sparing technique in breast RT, but about one-third of the patients do not benefit from that otherwise laborious procedure or benefit less than from an alternative method. Trial registration: retrospectively registered under ISRCTN14360721 (February 12, 2021)

PO-1480: Position in breast cancer radiotherapy: dosimetry and toxicity

2020 ◽  
Vol 152 ◽  
pp. S795-S796
Author(s):  
D. Hernandez ◽  
M.S. Talaya ◽  
C. Anson ◽  
P. Castro ◽  
M. Roch ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Radiotherapy ◽  
Breast Cancer Radiotherapy ◽  
Radiotherapy Dosimetry

PH-0163: Harmonization of breast cancer radiotherapy treatment planning in the Netherlands

2020 ◽  
Vol 152 ◽  
pp. S77-S78
Author(s):  
M. Verhoeven ◽  
M. Sangen van der ◽  
C. Hurkmans ◽  
L. Boersma ◽  
K. Verhoeven ◽  
...  
Keyword(s):  
Breast Cancer ◽  
The Netherlands ◽  
Treatment Planning ◽  
Radiotherapy Treatment Planning ◽  
Cancer Radiotherapy ◽  
Breast Cancer Radiotherapy ◽  
Radiotherapy Treatment
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