2 results
Radiation dose to the heart with hypofractionation in patients with left breast cancer
- Budhi Singh Yadav, Deepak Kumar Das, Narendra Kumar, Manphool Singhal, Ngangom Robert
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- Journal:
- Experimental Results / Volume 2 / 2021
- Published online by Cambridge University Press:
- 14 July 2021, e21
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- Article
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Introduction
In this study we compared radiation dose received by organs at risk (OARs) after breast conservation surgery(BCS) and mastectomy in patients with left breast cancer.
Materials and methodsTotal 30 patients, 15 each of BCS and mastectomy were included in this study. Planning Computerised Tomography (CT) was done for each patient. Chest wall, whole breast, heart, lungs, LAD, proximal and distal LAD, and contra lateral breast was contoured for each patient. Radiotherapy plans were made by standard tangent field. Dose prescribed was 40Gy/16#/3 weeks. Mean heart dose, LAD, proximal and distal LAD, mean and V5 of right lung, and mean, V5, V10 and V20 of left lung, mean dose and V2 of contra lateral breast were calculated for each patient and compared between BCS and mastectomy patients using student’s T test.
ResultsMean doses to the heart, LAD, proximal LAD and distal LAD were 3.364Gy, 16.06Gy, 2.7Gy, 27.5Gy; and 4.219Gy, 14.653Gy, 4.306Gy, 24.6Gy, respectively for mastectomy and BCS patients. Left lung mean dose, V5, V10 and V20 were 5.96Gy, 16%, 14%, 12.4%; and 7.69Gy, 21%, 18% and 16% in mastectomy and BCS patients, respectively. There was no statistical significant difference in the doses to the heart and left lung between mastectomy and BCS. Mean dose to the right lung was significantly less in mastectomy as compared to BCS, 0.29Gy vs. 0.51Gy, respectively (p = 0.007). Mean dose to the opposite breast was significantly lower in patients with mastectomy than BCS (0.54Gy Vs 0.37Gy, p = 0.007). The dose to the distal LAD was significantly higher than proximal LAD both in BCS (24.6Gy Vs 4.3Gy, p = <0.0001) and mastectomy (27.5Gy Vs 2.7Gy, p = <0.0001) patients.
ConclusionThere was no difference in doses received by heart and left lung between BCS and mastectomy patients. Mean doses to the right lung and breast were significantly less in mastectomy patients.
LINAC-based stereotactic radiosurgery/radiotherapy for brain metastases in patients with breast cancer
- Ankita Gupta, Budhi Singh Yadav, Nagarjun Ballari, Namrata Das, Ngangom Robert
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- Journal:
- Journal of Radiotherapy in Practice / Volume 21 / Issue 3 / September 2022
- Published online by Cambridge University Press:
- 15 February 2021, pp. 351-359
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Background:
Brain metastases (BM) are common in patients with HER2-positive and triple-negative breast cancer. In this study we aim to report clinical outcomes with LINAC-based stereotactic radiosurgery/radiotherapy (SRS/SRT) for BM in patients of breast cancer.
Methods:Clinical and dosimetric records of breast cancer patients treated for BM at our institute between May, 2015 and December, 2019 were retrospectively reviewed. Patients of previously treated or newly diagnosed breast cancer with at least a radiological diagnosis of BM; 1–4 in number, ≤3·5 cm in maximum dimension, with a Karnofsky Performance Score of ≥60 were taken up for treatment with SRS. SRT was generally considered if a tumour was >3·5 cm in diameter, near a critical or eloquent structure, or if the proximity of moderately sized tumours would lead to dose bridging in a single-fraction SRS plan. The median prescribed SRS dose was 15 Gy (range 7–24 Gy) and SRT dose was 27 Gy in 3 fractions.
Clinical assessment and MR imaging was done at 6 weeks post-SRS and then every 3 months thereafter. Intracranial progression-free survival (PFS) and overall survival (OS) were calculated using Kaplan–Meier method and subgroups were compared using log rank test.
Results:Total, 40 tumours were treated in 31 patients. The median tumour diameter was 2·3 cm (range 1·0–4·6 cm). SRS and SRT were delivered in 27 and 4 patients, respectively. SRS/SRT was given as a boost to whole brain radiotherapy (WBRT) in four patients and as salvage for progression after WBRT in six patients. In general, nine patients underwent prior surgery. The median follow-up was 7·9 months (0·2–34 months). Twenty (64·5%) patients developed local recurrence, 10 (32·3%) patients developed distant intracranial relapse and 7 patients had both local and distant intracranial relapse. The estimated local control at 6 months and 1 year was 48 and 35%, respectively. Median intracranial progression free survival (PFS) was 3·73 months (range 0·2–25 months). Median intracranial PFS was 3·02 months in patients who received SRS alone or as boost after WBRT, while it was 4·27 months in those who received SRS as salvage after WBRT (p = 0·793). No difference in intracranial PFS was observed with or without prior surgery (p = 0·410). Median overall survival (OS) was 21·7 months (range 0·2–34 months) for the entire cohort. Patients who received prior WBRT had a poor OS (13·31 months) as compared to SRS alone (21·4 months; p = 0·699).
Conclusion:In patients with BM after breast cancer SRS alone, WBRT + SRS and surgery + SRS had comparable PFS and OS.