San Antonio Breast Cancer San Antonio Breast Cancer Symposium 2007 Highlights – Symposium 2007 Highlights – Radiotherapy Radiotherapy Kathleen C. Horst, M.D. Kathleen C. Horst, M.D. Assistant Professor Assistant Professor Department of Radiation Department of Radiation Oncology Oncology Stanford University Stanford University
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San Antonio Breast Cancer Symposium 2007 Highlights – Radiotherapy Kathleen C. Horst, M.D. Assistant Professor Department of Radiation Oncology Stanford.
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San Antonio Breast Cancer Symposium San Antonio Breast Cancer Symposium 2007 Highlights – Radiotherapy2007 Highlights – Radiotherapy
Kathleen C. Horst, M.D.Kathleen C. Horst, M.D.
Assistant ProfessorAssistant ProfessorDepartment of Radiation OncologyDepartment of Radiation Oncology
Stanford UniversityStanford University
Post-lumpectomy XRTTechniqueFractionationPartial Breast Irradiation
Post-mastectomy XRT
Nodal XRT
The Cambridge Breast Intensity Modulated Radiotherapy (IMRT) Trial: Dosimetry Results
Abstract # 4086 Coles, et al.
1089 patients with breast cancer treated with BCT
Standard treatment plan
< 2 cm3 of breast tissue > 107% > 2 cm3 of breast tissue > 107%
Non-randomized Randomized
Standard RT IMRT
317/1089 (29%) had acceptable homogeneity with standard 2D radiotherapy.
IMRT significantly reduced both “hot spots” and “cold spots”.
The Cambridge Breast Intensity Modulated Radiotherapy (IMRT) Trial: Dosimetry Results
Abstract # 4086 Coles, et al.
Prospective trial of individual optimal positioning (prone vs supine) for whole breast radiotherapy: results of 224 patients
Abstract # 4082 Formenti, et al.
Prospective trial of individual optimal positioning (prone vs supine) for whole breast radiotherapy: results of 224 patients
Abstract # 4082 Formenti, et al.
CONCLUSIONS:Prone enables best sparing of heart and lung in most patients (204/224)Most patients best treated supine (17/20) had left-sided lesions
When prone, heart is displaced anteriorly 5-19 mm (Duke)May limit utility of prone technique
Node-NegativePost BCS
1234 patients
Accelerated Hypofractionated Whole Breast Irradiation (AHWBI)
42.5 Gy/16 fractions622 patients
Standard Whole Breast Irradiation (SWBI)
50 Gy/25 fractions612 patients
Stratification: Age Size Systemic tx Center
Recruitment April ’93- Sept ’96
R
Radiotherapy Fractionation SchedulesRadiotherapy Fractionation SchedulesAbstract #21 Whelan, et al.
Long-term results of a randomized trial of accelerated hypofractionated whole breast irradiation following breast conserving surgery in women with node negative breast cancer