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EP-1140: Dosimetric comparison between Helical Tomotherapy and IMRT for Bilateral Breast Cancer
S621 ESTRO 36 _______________________________________________________________________________________________
EP-1140 Dosimetric comparison between Helical Tomotherapy and IMRT for Bilateral Breast Cancer M.H. Wang1 1 Shuang Ho Hospital, Department of Radiation Oncology, Taipei, Taiwan Purpose or Objective This study aimed to compare treatment between Tomotherapy and IMRT for bilateral breast cancer. Material and Methods We selected 10 patients of breast cancer who were performed partial mastectomy for study. All patient were early stage breast cancer pT1~T2. A total dose of 5040cGy was delivered for definitive breast irradiation of IMRT and Tomotherapy for each patient in treatment planning system. In this study, we analyzed comparable treatment of IMRT vs Tomotherapy for bilateral breast. Bilateral whole breast dose coverage, Conformity index, Homogeneity index and dose volume constraints of normal tissue (Right and Left lung, Heart) were analyzed. Results Tomotherapy was better than IMRT for significant improvements in reducing the volume of normal tissue. In volume of heart in V20 (Tomo:1.543% versus IMRT: 2.955%; p=0.023) and in lung volume achieving lower mean lung dose (MLD) (Rt lung mean dose: Tomo: 6.388 Gy versus IMRT: 8.828Gy; p = 0.017; Lt lung mean dose Tomo: 6.24 Gy versus IMRT: 7.71Gy; p = 0.013). The conformity indices (V95%/VPTV) of right and left breast were (1.08 +/- 0.01) & (1.07 +/- 0.02) in Tomo and (1.07 +/-0.02) & (1.08 +/0.01) in IMRT. For homogeneity indices, Tomo were (1.36 +/- 0.08) & (1.53+/- 0.46) and IMRT was (1.65 +/- 0.44) & (1.51 +/- 0.26) in right and left breast. Conclusion Tomotherapy provided significant reduction in heart’s dose volume and mean lung dose. EP-1141 Acute and late toxicity of IORT during BCS followed by whole breast radiotherapy (WBI). B. Urbanski1, A. Roszak Andrzej1, K. Bratos1, P. Milecki2, A. Karczewska-Dzionk3, M. Litoborski4, S. Adamczyk5 1 Greater Poland Cancer Centre, Radiotherapy and Gynecological Oncology, Poznan, Poland 2 Greater Poland Cancer Centre, Radiotherapy Ward I, Poznan, Poland 4 Candela, Candela, Warsaw, Poland 5 Intra Op, Intra Op, Sunnyvale, USA Purpose/Objective: The aim of the study was to report acute and late toxicity of intraoperative radiotherapy (IORT) given as a boost during breast conserving surgery (BCS) followed by adjuvant whole breast radiotherapy (WBRT).Material and Methods Between 2008 and 2011 in 150 breast cancers patients treated in Greater Poland Cancer Centre. Intraoperative radiotherapy as a tumor bed boost was applied using mobile electron accelerator Mobetron 1000 (IntraOp Medical, Inc.). IORT boost (10 Gy) was followed by 50 Gy whole-breast external beam radiotherapy (EBRT). Chemotherapy, if indicated, was given before EBRT. The observation period was 1,5-5,5 years. The data was assessed by CTCAE ver. 3.0 scale 1 month and 6 months after RT. The statistical analysis was performed with Maentel-Haenszel test. Late toxicity was analyzed with LENT-SOMA scale 1 year after RT.
Results Tab 1. Acute toxicity data set.
There was only grade I and II acute toxicity reactions. There was no statistical significance differences between (Mantel-Haenszel test) percentage of patients with acute reaction in 1 month and 6 months after RT. Tab 2. Late toxicity data set.
The late toxicity occurred in 82 patients (55%). The main side effect of treatment was fibrosis, which has occurred in 60 patients (73.1%) from 82 in general with late radiation induced reactions. There was grade I and II predominance. Grade III occurred in 5 patients (skin retraction). Conclusion Intraoperative radiotherapy is proved to be safe, well tolerable and perspective treatment procedure in breast cancer treatment. EP-1142 EORTC QLQ C-30 scores evolution in stage I-III breast cancer patients during sequential treatment A. Vila1, J. Perez de Olaguer1, P. Gallego1, G. Carrera1, A. Pedro1 1 Platón Hospital, Oncology and Radiation therapy, Barcelona, Spain Purpose or Objective To analyse the quality of life in stage I-III breast cancer patients under systemic treatment versus in adjuvant radiotherapy respect a control group, to observe and to assess priorities regarding quality of life Material and Methods Between May and July of 2014, n: 90 EORTC QLQ C-30 global tests were retrospectively observed in 48 women divided in 3 groups: A) Sixteen breast cancer patients under systemic treatment (following adjuvant chemotherapy or hormonal treatment). B) Sixteen breast cancer patients following radiotherapy were scored at the beginning, during radiotherapy and when radiotherapy courses just ended. C) Sixteen women, hospital workers, without cancer control group, which two were finally refused because they had symptoms of chronic fatigue Results Women mean ages were 63.5 years old (A), 60.5 years old (B) and 41 years old in group C, respectively. Among those 32 breast cancer patient (n: 76 tests), 6 (19%) were submitted to mastectomy and 26 (81%) to conservative surgery, with 5 of them that had been treated with neo - adjuvant chemotherapy. Breast cancer (TNM) stage was I, II or III in 50%, 37.5% and 12.5%, respectively. Asthenia was the main symptom in all cases being low in control group. However, asthenia was considerable or severe in the 56% of cases in the systemic treatment group and 27.5% in radiotherapy group. Asthenia increases a 6%
EP-1140 Dosimetric comparison between Helical Tomotherapy and IMRT for Bilateral Breast Cancer M.H. Wang1 1 Shuang Ho Hospital, Department of Radiation Oncology, Taipei, Taiwan Purpose or Objective This study aimed to compare treatment between Tomotherapy and IMRT for bilateral breast cancer. Material and Methods We selected 10 patients of breast cancer who were performed partial mastectomy for study. All patient were early stage breast cancer pT1~T2. A total dose of 5040cGy was delivered for definitive breast irradiation of IMRT and Tomotherapy for each patient in treatment planning system. In this study, we analyzed comparable treatment of IMRT vs Tomotherapy for bilateral breast. Bilateral whole breast dose coverage, Conformity index, Homogeneity index and dose volume constraints of normal tissue (Right and Left lung, Heart) were analyzed. Results Tomotherapy was better than IMRT for significant improvements in reducing the volume of normal tissue. In volume of heart in V20 (Tomo:1.543% versus IMRT: 2.955%; p=0.023) and in lung volume achieving lower mean lung dose (MLD) (Rt lung mean dose: Tomo: 6.388 Gy versus IMRT: 8.828Gy; p = 0.017; Lt lung mean dose Tomo: 6.24 Gy versus IMRT: 7.71Gy; p = 0.013). The conformity indices (V95%/VPTV) of right and left breast were (1.08 +/- 0.01) & (1.07 +/- 0.02) in Tomo and (1.07 +/-0.02) & (1.08 +/0.01) in IMRT. For homogeneity indices, Tomo were (1.36 +/- 0.08) & (1.53+/- 0.46) and IMRT was (1.65 +/- 0.44) & (1.51 +/- 0.26) in right and left breast. Conclusion Tomotherapy provided significant reduction in heart’s dose volume and mean lung dose. EP-1141 Acute and late toxicity of IORT during BCS followed by whole breast radiotherapy (WBI). B. Urbanski1, A. Roszak Andrzej1, K. Bratos1, P. Milecki2, A. Karczewska-Dzionk3, M. Litoborski4, S. Adamczyk5 1 Greater Poland Cancer Centre, Radiotherapy and Gynecological Oncology, Poznan, Poland 2 Greater Poland Cancer Centre, Radiotherapy Ward I, Poznan, Poland 4 Candela, Candela, Warsaw, Poland 5 Intra Op, Intra Op, Sunnyvale, USA Purpose/Objective: The aim of the study was to report acute and late toxicity of intraoperative radiotherapy (IORT) given as a boost during breast conserving surgery (BCS) followed by adjuvant whole breast radiotherapy (WBRT).Material and Methods Between 2008 and 2011 in 150 breast cancers patients treated in Greater Poland Cancer Centre. Intraoperative radiotherapy as a tumor bed boost was applied using mobile electron accelerator Mobetron 1000 (IntraOp Medical, Inc.). IORT boost (10 Gy) was followed by 50 Gy whole-breast external beam radiotherapy (EBRT). Chemotherapy, if indicated, was given before EBRT. The observation period was 1,5-5,5 years. The data was assessed by CTCAE ver. 3.0 scale 1 month and 6 months after RT. The statistical analysis was performed with Maentel-Haenszel test. Late toxicity was analyzed with LENT-SOMA scale 1 year after RT.
Results Tab 1. Acute toxicity data set.
There was only grade I and II acute toxicity reactions. There was no statistical significance differences between (Mantel-Haenszel test) percentage of patients with acute reaction in 1 month and 6 months after RT. Tab 2. Late toxicity data set.
The late toxicity occurred in 82 patients (55%). The main side effect of treatment was fibrosis, which has occurred in 60 patients (73.1%) from 82 in general with late radiation induced reactions. There was grade I and II predominance. Grade III occurred in 5 patients (skin retraction). Conclusion Intraoperative radiotherapy is proved to be safe, well tolerable and perspective treatment procedure in breast cancer treatment. EP-1142 EORTC QLQ C-30 scores evolution in stage I-III breast cancer patients during sequential treatment A. Vila1, J. Perez de Olaguer1, P. Gallego1, G. Carrera1, A. Pedro1 1 Platón Hospital, Oncology and Radiation therapy, Barcelona, Spain Purpose or Objective To analyse the quality of life in stage I-III breast cancer patients under systemic treatment versus in adjuvant radiotherapy respect a control group, to observe and to assess priorities regarding quality of life Material and Methods Between May and July of 2014, n: 90 EORTC QLQ C-30 global tests were retrospectively observed in 48 women divided in 3 groups: A) Sixteen breast cancer patients under systemic treatment (following adjuvant chemotherapy or hormonal treatment). B) Sixteen breast cancer patients following radiotherapy were scored at the beginning, during radiotherapy and when radiotherapy courses just ended. C) Sixteen women, hospital workers, without cancer control group, which two were finally refused because they had symptoms of chronic fatigue Results Women mean ages were 63.5 years old (A), 60.5 years old (B) and 41 years old in group C, respectively. Among those 32 breast cancer patient (n: 76 tests), 6 (19%) were submitted to mastectomy and 26 (81%) to conservative surgery, with 5 of them that had been treated with neo - adjuvant chemotherapy. Breast cancer (TNM) stage was I, II or III in 50%, 37.5% and 12.5%, respectively. Asthenia was the main symptom in all cases being low in control group. However, asthenia was considerable or severe in the 56% of cases in the systemic treatment group and 27.5% in radiotherapy group. Asthenia increases a 6%