TY - JOUR AU - Kovács, Árpád AU - Hadjiev, Janaki AU - Lakosi, Ferenc AU - Glavák, Csaba AU - Antal, Gergely AU - Bogner, Péter AU - Horváth, Ákos AU - Repa, Imre TI - Comparison of photon with electron boost in treatment of early stage breast cancer JF - PATHOLOGY AND ONCOLOGY RESEARCH J2 - PATHOL ONCOL RES VL - 14 PY - 2008 IS - 2 SP - 193 EP - 197 PG - 5 SN - 1219-4956 DO - 10.1007/s12253-008-9015-2 UR - https://m2.mtmt.hu/api/publication/1369693 ID - 1369693 AB - In the treatment of early stage breast cancer breast conserving surgery (BCS) followed by whole breast irradiation (WBI) is a standard method. The impact of the tumor bed boost following WBI is well-defined, but there are various delivery methods. In this study the electron and the photon boost techniques were compared. For 78 early stage breast cancer patients both CT based 3D conformal photon boost and electron boost plans were created. For dosimetric comparison coverage index (CI), external volume index (EI) and conformality index (COIN) were studied. Lung volume receiving a dose of 2 Gy was also reviewed. Seventy-eight patients with 156 plans were compared. The mean tumor bed volume was measured as 61.39 cm3 the mean tumor bed-skin distance was 3.13 cm. In the case of CI and COIN significant differences were found in favor of the photon boost. In the comparison of EI no significant difference was detected between the two techniques. The mean lung volume receiving 2 Gy were 42.3 and 168.35 cm3, for photons and electrons respectively. In the adjuvant treatment of early stage breast cancer WBI followed by conformal photon boost showed to be superior to electron boost in focus of the COIN and CI. LA - English DB - MTMT ER - TY - JOUR AU - Lovey, K AU - Fodor, János AU - Major, Tibor AU - Szabo, E AU - Orosz, Zsolt AU - Sulyok, Z AU - Jánváry, Zsolt Levente AU - Fröhlich, Georgina AU - Kásler, Miklós AU - Polgár, Csaba TI - Fat necrosis after partial-breast irradiation with brachytherapy or electron irradiation versus standard whole-breast radiotherapy--4-year results of a randomized trial. JF - INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS J2 - INT J RADIAT ONCOL VL - 69 PY - 2007 IS - 3 SP - 724 EP - 731 PG - 8 SN - 0360-3016 DO - 10.1016/j.ijrobp.2007.03.055 UR - https://m2.mtmt.hu/api/publication/1118079 ID - 1118079 N1 - Megjegyzés-20317363 Cited By (since 1996): 1 AB - PURPOSE: To examine the incidence and clinical relevance of fat necrosis after accelerated partial-breast irradiation (PBI) using interstitial high-dose-rate brachytherapy (HDR-BT) in comparison with partial-breast electron irradiation (ELE) and whole-breast irradiation (WBI). METHODS AND MATERIALS: Between 1998 and 2004, 258 early-stage breast cancer patients were randomized to receive 50 Gy WBI (n = 130) or PBI (n = 128). The latter consisted of either 7 x 5.2 Gy HDR-BT (n = 88) or 50 Gy ELE (n = 40). The incidence of fat necrosis, its impact on cosmetic outcome, accompanying radiologic features, and clinical symptoms were evaluated. RESULTS: The 4-year actuarial rate of fat necrosis was 31.1% for all patients, and 31.9%, 36.5%, and 17.7% after WBI, HDR-BT and ELE, respectively (p(WBI/HDR-BT) = 0.26; p(WBI/ELE) = 0.11; p(ELE/HDR-BT) = 0.025). The respective rate of asymptomatic fat necrosis was 20.2%, 25.3%, and 10% of patients. The incidence of symptomatic fat necrosis was not significantly different after WBI (8.5%), HDR-BT (11.4%), and ELE (7.5%). Symptomatic fat necrosis was significantly associated with a worse cosmetic outcome, whereas asymptomatic fat necrosis was not. Fat necrosis was detectable with mammography and/or ultrasound in each case. Additional imaging examinations were required in 21% of cases and aspiration cytology in 42%. CONCLUSIONS: Asymptomatic fat necrosis is a common adverse event of breast-conserving therapy, having no significant clinical relevance in the majority of the cases. The incidence of both symptomatic and asymptomatic fat necrosis is similar after conventional WBI and accelerated partial-breast HDR-BT. LA - English DB - MTMT ER - TY - JOUR AU - Polgár, Csaba AU - Fodor, János AU - Major, Tibor AU - Orosz, Zsolt AU - Németh, György TI - The role of boost irradiation in the conservative treatment of stage I-II breast cancer. JF - PATHOLOGY AND ONCOLOGY RESEARCH J2 - PATHOL ONCOL RES VL - 7 PY - 2001 IS - 4 SP - 241 EP - 250 PG - 10 SN - 1219-4956 DO - 10.1007/BF03032380 UR - https://m2.mtmt.hu/api/publication/1118041 ID - 1118041 N1 - Department of Radiotherapy, National Institute of Oncology, Ráth György u. 7-9, Budapest, H-1122, Hungary Department of Pathology, National Institute of Oncology, Budapest, Hungary Cited By :42 Export Date: 13 January 2023 Correspondence Address: Polgár, C.; National Institute of Oncology, Ráth György u. 7-9, Budapest H-1122, Hungary; email: polgar@oncol.hu AB - In this article, we review the current status, indication, technical aspects, controversies, and future prospects of boost irradiation after breast conserving surgery (BCS). BCS and radiotherapy (RT) of the conserved breast became widely accepted in the last decades for the treatment of early invasive breast cancer. The standard technique of RT after breast conservation is to treat the whole breast up to a total dose of 45 to 50 Gy. However, there is no consensus among radiation oncologists about the necessity of boost dose to the tumor bed. Generally accepted criteria for identification of high risk subgroups, in which boost is recommended, have not been established yet. Further controversy exists regarding the optimal boost technique (electron vs. brachytherapy), and their impact on local tumor control and cosmesis. Based on the results of numerous retrospective and recently published prospective trials, the European brachytherapy society (GEC-ESTRO), as well as the American Brachytherapy Society has issued their guidelines in these topics. These guidelines will help clinicians in their medical decisions. Some aspects of boost irradiation still remain somewhat controversial. The final results of prospective boost trials with longer follow-up, involving analyses based on pathologically defined subgroups, will clarify these controversies. Preliminary results with recently developed boost techniques (intraoperative RT, CT-image based 3D conformal brachytherapy, and 3D virtual brachytherapy) are promising. However, more experience and longer follow-up are required to define whether these methods might improve local tumor control for breast cancer patients treated with conservative surgery and RT. LA - English DB - MTMT ER -