Recent Advances in Breast Radiotherapy
|
|
- Teresa Wilson
- 6 years ago
- Views:
Transcription
1 Recent Advances in Breast Radiotherapy Dr Anna Kirby Consultant Clinical Oncologist
2 2 The Royal Marsden Overview: Key innovations 1. 2D to 3D planning 2. Hypofractionation 3. Intensity modulated radiotherapy 4. Tumour bed localisation 5. Heart-sparing breast radiotherapy 6. Risk-adapted radiotherapy 7. Intra-operative radiotherapy
3 3 The Royal Marsden Overview: Key innovations 1. 2D to 3D planning 2. Hypofractionation Increasing efficacy 3. Intensity modulated radiotherapy 4. Tumour bed localisation Reducing side-effects 5. Heart-sparing breast radiotherapy 6. Risk-adapted radiotherapy 7. Intra-operative radiotherapy
4 2D to 3D planning
5 2D-planned radiotherapy Primary Beam
6 Potential for missing tumour bed
7 Potentially large normal tissue doses
8 2D vs 3D radiotherapy dose distributions Courtesy: Ellen Donovan
9 Full 3D optimisation
10 3D planning: the benefits Increases accuracy Allows optimisation of breast coverage vs normal tissue doses Reduces late side-effects including breast shrinkage, firmness, pain and rib fracture 80% of UK RT centres offer 3D dose optimisation (RCR audit 2012)
11 Hypofractionation
12 START Trial START Trial B Trial B N= Gy in 25 # (2.0Gy) 5 wks N= Gy in 15 # (2.67Gy) 3 wks N= years median follow-up
13 Trial B : Local-regional (LR) tumour relapse % of patients with no LR relapse Gy (29 / 1110) 50 Gy (36 / 1105) Cumulative hazard rate Gy Gy Years since randomisation Number at risk: Yr 0 Yr 1 Yr 2 Yr 3 Yr 4 Yr 5 Yr Years since randomisation Hazard Ratio (95%CI) Absolute difference at 5 yr (95%CI) 40 Gy vs. 50 Gy 0.79 ( ) -0.6% (-1.7% 0.9%)
14 Trial B: Change in breast appearance % of patients with no change in breast appearance Gy/15F (145 / 462) 50 Gy/25F (167 / 461) Years since randomisation Number Yr 0 Yr 2 Yr 5 at risk: Hazard Ratios (95%CI) Absolute difference at 5 yr (95%CI) 40 Gy vs. 50 Gy 0.83 ( ) -5.6% (-11.8% 1.2%)
15 40Gy vs. 50Gy The Royal Marsden Trial B : Late normal tissue effects PATIENT self-assessment (moderate or marked) PHYSICIAN assessment of (moderate or marked) 40Gy better 50Gy better 40Gy better 50Gy better Shrinkage Hardness Skin appearance Breast appearance Swelling Shrinkage Induration Telangiectasia Oedema Hazard Ratio (95% CI) Hazard Ratio (95% CI)
16 Standard RT Regimens are Changing Total dose (Gy) Number fractions Fraction size (Gy) Time (weeks) International Standard New UK Standard
17 Advantages of hypofractionated breast RT Reduced acute and late side-effects Trend towards greater efficacy Easier to integrate with surgery & systemic therapies More convenient for patients
18 Intensity modulated radiotherapy (IMRT)
19 Simple forward-planned IMRT: step and shoot Open Field Segmented Field
20 Simple forward-planned IMRT: step and shoot
21 Inverse-planned IMRT Pectus excavatum Internal mammary chain Bilateral breast RT
22 Volumetric modulated arc therapy
23 Tumour bed localisation
24 Tumour bed localisation Cavity visualisation scores Landis et al, IJROBP, 2007?
25 Oncoplastic surgery: scar tumour bed
26 Marker-based tumour bed localisation IMPORT HIGH Trial Planning Pack
27 Boost planning based on markers Clips Skin entry point Excision cavity IMPORT High Trial, RMH Sutton
28 Heart-sparing radiotherapy
29 Addition of RT to BCS improves local control & survival Early Breast Cancer Triallists Collaborative Group, Lancet, 2005
30 but increases non breast cancer mortality Early Breast Cancer Trialists Collaborative Group, Lancet, 2005
31 Standard tangents often result in high doses to cardiac tissues esp LAD Courtesy: Jane Dobbs
32 32 The Royal Marsden NCRI Conference, Liverpool Heart-sparing breast RT techniques Multileaf collimation (MLC) IMRT Prone Breath-hold
33 33 The Royal Marsden NCRI Conference, Liverpool UK HeartSpare Study (NIHR funded) ABC_DIBH v_dibh vs Digital spirometer Monitoring Visual Good data Reproducibility Data lacking Expensive Cost Cheap
34 34 The Royal Marsden NCRI Conference, Liverpool HeartSpare: Example of heart-sparing achieved in breath-hold Free breathing v_dibh ABC_DIBH
35 Risk-adapted radiotherapy
36 Risk-adapted radiotherapy Holland et al, Cancer 1985
37 IMPORT HIGH dose escalation study 2.4Gy 2.7Gy 3.2Gy 15 Fractions (3 weeks) Courtesy: Dr C Coles, Addenbrooke s Hospital
38 Brings together advances in planning, fractionation & localisation 3fld boost 5fld boost
39 Requires real time verification of position of tumour bed markers RT beam Cone beam imaging
40 Tumour bed clips make automated set-up possible 1 st day of RT Cone beam Planning CT Adjusted IMPORT High Trial, RMH Sutton
41 Partial breast radiotherapy
42 Partial breast irradiation techniques Intraoperative techniques Intrabeam (TARGIT) ELIOT (Italy) Post-operative techniques Mammosite (US) External beam RT (UK and US)
43 Intrabeam (TARGIT) Intra-operative RT 50kV photons via 3.2mm diam tube for 25-30mins >45yrs, eligible for BCT Mean FU 60mths, 5yr LRR 1.7% Vaidya et al, IJROBP 2011
44 Mammosite Post-operative Balloon 30% seroma rate, 10% infection rate, 90% good cosmesis at med FU of 72 mths Vicini IJROBP 2011
45 External beam partial breast irradiation Treats 25mm margin around tumour bed Full path report available Coles &Yarnold, UK
46 Partial breast irradiation Currently available in trial setting only Awaiting long-term follow-up of a number of studies Likely to be available to limited subgroups of women in the medium term
47 47 The Royal Marsden Change Presentation title and date in Footer dd.mm.yyyy Advances in breast RT: what do these mean for your patients? Most women can be treated in 3-4 weeks with reduced risk of late-side effects due to Homogeneous 3D-doses Reduced total dose to normal tissues Use of heart-sparing techniques Accuracy of treatment is within mm due to 3D anatomical information Tumour bed markers
48 The future of breast radiotherapy Ongoing studies in risk-adapted radiotherapy aim to individualise treatment further Improved imaging techniques will help guide use of nodal irradiation Likely to be delivering less RT in future Either less tissue treated Or no RT Indications for intra-operative radiotherapy likely to increase
Breast Cancer Radiotherapy: Clinical challenges in 2011 from a European Perspective. Dr DA WHEATLEY CONSULTANT ONCOLOGIST ROYAL CORNWALL HOSPITAL
Breast Cancer Radiotherapy: Clinical challenges in 2011 from a European Perspective Dr DA WHEATLEY CONSULTANT ONCOLOGIST ROYAL CORNWALL HOSPITAL Radiotherapy in Early Breast Cancer Why do we do it? Who
More informationHypofractionated Radiotherapy for breast cancer: Updated evidence
2 rd Bangladesh Breast Cancer Conference, Dhaka, December 2017 Hypofractionated Radiotherapy for breast cancer: Updated evidence Tabassum Wadasadawala Associate Professor of Radiation Oncology Tata Memorial
More informationAdvances in external beam radiotherapy
International Conference on Modern Radiotherapy: Advances and Challenges in Radiation Protection of Patients Advances in external beam radiotherapy New techniques, new benefits and new risks Michael Brada
More informationRADIOTHERAPY IN BREAST CANCER :
RADIOTHERAPY IN BREAST CANCER : PAST, PRESENT, FUTURE Dr Jyotirup Goswami Consultant Radiation Oncologist Narayana Cancer Institute Narayana Superspecialty Hospital Breast cancer is the classic paradigm
More informationThe Impact of Image Guided Radiotherapy in Breast Boost Radiotherapy
The Impact of Image Guided Radiotherapy in Breast Boost Radiotherapy 1 Donovan EM, 1 Brooks C, 1 Mitchell A, 2 Mukesh M, 2 Coles CE, 3 Evans PM, 1 Harris EJ 1 Joint Department of Physics, The Royal Marsden/Institute
More informationKenny Guida, DMP, DABR March 21 st, 2015
Kenny Guida, DMP, DABR March 21 st, 2015 Breast Cancer Treatment planning and delivery Hypofractionation Trials Hybrid Planning History Techniques RTOG 1005 Trial Hybrid-VMAT Research project 3D Tangents
More informationIntraoperative. Radiotherapy
Intraoperative Radiotherapy ROBERTO ORECCHIA UNIVERSITY of MILAN & EUROPEAN INSTITUTE of ONCOLOGY & CNAO FOUNDATION Breast Cancer Brescia, 30th September 2011 IORT, very selective technique to intensify
More informationHow can we Personalize RT as part of Breast-Conserving Therapy?
How can we Personalize RT as part of Breast-Conserving Therapy? Jay R. Harris Dana-Farber Cancer Institute (DFCI) Brigham and Women s Hospital (BWH) Harvard Medical School Disclosures I have no COI disclosures
More informationPartial Breast Irradiation using adaptive MRgRT
Partial Breast Irradiation using adaptive MRgRT Shyama Tetar, radiation-oncologist VUmc Amsterdam 15-12-2017 5 th Vumc SBRT symposium 2017 Current practice Breast conserving treatment (BCT) Breast conserving
More informationThe Physics of Oesophageal Cancer Radiotherapy
The Physics of Oesophageal Cancer Radiotherapy Dr. Philip Wai Radiotherapy Physics Royal Marsden Hospital 1 Contents Brief clinical introduction Imaging and Target definition Dose prescription & patient
More informationPartial Breast Irradiation for Breast Conserving Therapy
To Radiate or Not? Is APBI the Right Compromise Solution? Partial Breast Irradiation for Breast Conserving Therapy Julia White MD Professor, Radiation Oncology Agenda Role of radiotherapy in breast conservation
More informationNew Technologies in Radiation Oncology. Catherine Park, MD, MPH Advocate Good Shepherd Hospital
New Technologies in Radiation Oncology Catherine Park, MD, MPH Advocate Good Shepherd Hospital Breast Radiation Early Stage Breast Cancer Whole Breast Radiation Delivered to the whole breast Boost to the
More informationSan Antonio Breast Cancer Symposium 2010 Highlights Radiotherapy
San Antonio Breast Cancer Symposium 2010 Highlights Radiotherapy Kathleen C. Horst, M.D. Assistant Professor Department of Radiation Oncology Stanford University The Optimal SEquencing of Adjuvant Chemotherapy
More informationWhole Breast Irradiation: Class vs. Hypofractionation
Whole Breast Irradiation: Class vs. Hypofractionation Kyung Hwan Shin, MD, PhD. Dept. of Radiation Oncology, Seoul National University Hospital 2018. 4. 6. GBCC Treatment Trends of Early Breast Cancer
More informationNSABP PROTOCOL B-39B RTOG PROTOCOL 0413
NSABP PROTOCOL B-39B RTOG PROTOCOL 0413 (A RANDOMIZED PHASE III STUDY OF CONVENTIONAL WHOLE BREAST IRRADIATION WBI) VERSUS PARTIAL BREAST IRRADIATION (PBI) FOR WOMEN WITH STAGE 0, I, OR II BREAST CANCER
More informationAccelerated Partial Breast Irradiation
Accelerated Partial Breast Irradiation OSCO/OU Stephenson Cancer Center Saturday, March 5, 2016 Robert Kuske, MD, FAACE Founder, Medical Director Arizona Breast Cancer Specialists Scottsdale, Arizona 1
More informationCorporate Medical Policy
Corporate Medical Policy Breast Brachytherapy for Accelerated Partial Breast Radiotherapy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: breast_brachytherapy_for_accelerated_partial_breast_radiotherapy
More informationCorporate Medical Policy
Corporate Medical Policy Intensity Modulated Radiation Therapy (IMRT) of Abdomen and File Name: Origination: Last CAP Review: Next CAP Review: Last Review: intensity_modulated_radiation_therapy_imrt_of_abdomen_and_pelvis
More informationAccelerated Partial Breast Irradiation. Dr Patricia Lillis MD, MHA,MSS Marshfield Clinic Radiation Oncology
Accelerated Partial Breast Irradiation Dr Patricia Lillis MD, MHA,MSS Marshfield Clinic Radiation Oncology Outline 1. Rationale 2. Review of selected literature 3. Technical aspects 4. Selection criteria
More informationNitesh N. Paryani, M.D. First Radiation & Oncology Group Instructor of Radiation Oncology, Mayo Clinic Courtesy Professor, University of Florida
Nitesh N. Paryani, M.D. First Radiation & Oncology Group Instructor of Radiation Oncology, Mayo Clinic Courtesy Professor, University of Florida I Invasive Breast Brachytherapy Non-invasive Image-guided
More informationRecent Advances in Breast Cancer Treatment
Recent Advances in Breast Cancer Treatment Pornchai O-charoenrat MD, PhD, FRCST, FICS Professor Chief, Division of Head-Neck & Breast Surgery Department of Surgery, Siriraj Hospital, THAILAND Recent Advances
More informationWhy Choose Brachytherapy and Not External Beam RT or IORT?
May 30 31, 2014 Miami Beach, FL USA Why Choose Brachytherapy and Not External Beam RT or IORT? Csaba Polgár, MD, PhD, MSc National Institute of Oncology Budapest, Hungary 1 Disclosure Csaba Polgár, MD,
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
Accelerated Breast Irradiation and Brachytherapy Boost Page 1 of 27 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Accelerated Breast Irradiation and Brachytherapy
More informationObjectives Intraoperative Radiation Therapy for Early Stage Breast Cancer
Objectives Intraoperative Radiation Therapy for Early Stage Breast Cancer Cristina Lopez-Peñalver, MD, FACS October 11, 2014 Disclosures I have no relevant commercial relationships to disclose. Discuss
More informationIntra operative Intrabeam radiation for breast cancer
Intra operative Intrabeam radiation for breast cancer Dr Gillian Campbell Radiation Oncologist May 2018 Disclaimer/Conflicts I am a radiation oncology consultant at Christchurch Hospital, Canterbury Breast
More informationCorporate Medical Policy
Corporate Medical Policy Intensity-Modulated Radiation Therapy (IMRT) of the Prostate File Name: Origination: Last CAP Review: Next CAP Review: Last Review: intensity_modulated_radiation_therapy_imrt_of_the_prostate
More informationCurrent Status of Accelerated Partial Breast Irradiation. Julia White MD Professor, Radiation Oncology
Current Status of Accelerated Partial Breast Irradiation Julia White MD Professor, Radiation Oncology I have no disclosures relative to the presented material Agenda ABPI Timeline APBI by Method Clinical
More informationBLADDER RADIOTHERAPY PLANNING DOCUMENT
A 2X2 FACTORIAL RANDOMISED PHASE III STUDY COMPARING STANDARD VERSUS REDUCED VOLUME RADIOTHERAPY WITH AND WITHOUT SYNCHRONOUS CHEMOTHERAPY IN MUSCLE INVASIVE BLADDER CANCER (ISRCTN 68324339) BLADDER RADIOTHERAPY
More informationRadiation Treatment for Breast. Cancer. Melissa James Radiation Oncologist August 2015
Radiation Treatment for Breast Cancer Melissa James Radiation Oncologist August 2015 OUTLINE External Beam Radiation treatment. (What is Radiation, doctor?) Role of radiation. (Why am I getting radiation,
More informationTomoTherapy. Michelle Roach CNC Radiation Oncology Liverpool Hospital CNSA. May 2016
TomoTherapy Michelle Roach CNC Radiation Oncology Liverpool Hospital CNSA May 2016 TomoTherapy The Facts Greek Tomo = slice Advanced form of IMRT 3D computerised tomography (CT) imaging immediately prior
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
Accelerated Breast Irradiation and Brachytherapy Boost Page 1 of 23 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Accelerated Breast Irradiation and Brachytherapy
More informationTechnology appraisal guidance Published: 31 January 2018 nice.org.uk/guidance/ta501
Intrabeam radiotherapy system for adjuvant treatment of early breast cancer Technology appraisal guidance Published: 31 January 2018 nice.org.uk/guidance/ta501 NICE 2018. All rights reserved. Subject to
More informationHypofractionation and positioning in breast cancer radiation. John Hardie, M.D., Ph.D. November 2016
Hypofractionation and positioning in breast cancer radiation John Hardie, M.D., Ph.D. November 2016 At McFarland/MGMC we treat early stage breast cancer with 42.4 Gy in 16 fractions, in the prone position.
More informationPost-Lumpectomy Radiation Techniques and Toxicities
Post-Lumpectomy Radiation Techniques and Toxicities Laura Willson, MD Abbott Northwestern Hospital Dept. of Radiation Oncology February 2, 2019 Learning Objectives How radiation therapy works Standard
More informationRadiotherapy Physics and Equipment
Radiological Sciences Department Radiotherapy Physics and Equipment RAD 481 Lecture s Title: Introduction Dr. Mohammed EMAM Ph.D., Paris-Sud 11 University Vision :IMC aspires to be a leader in applied
More informationHow can surgeons help the Radiation Oncologists?
How can surgeons help the Radiation Oncologists? Lorna Weir BC Surgical Oncology fall breast cancer update Oct 24, 2009 Disclosure no conflict of interest Outline Introduction OR reports Marking of surgical
More informationAccelerated Radiation Treatment for Early Stage Breast Cancer. update and perspective
Accelerated Radiation Treatment for Early Stage Breast Cancer update and perspective School of Breast Oncology Atlanta, 11/2013 Douglas W. Arthur, M.D. Professor Traditional Whole Breast Irradiation WBI
More informationFuture upcoming technologies and what audit needs to address
Future upcoming technologies and what audit needs to address Dr R.I MacKay History of audit Absolute dose - Simple phantom standard dose measurement Point doses in beams - Phantoms of relatively simple
More informationImplementation of Hybrid IMRT Breast Planning
Implementation of Hybrid IMRT Breast Planning Dianne Kearns, Richard Ferguson & Suzanne Smith Dosimetrist Manager Department of Clinical Physics and Bio-Engineering, NHS Greater Glasgow & Clyde Summary
More informationBrachytherapy is better than external beam therapy for partial breast irradiation
Brachytherapy is better than external beam therapy for partial breast irradiation For the proposition: Dorin Todor Virginia Commonwealth University, Richmond, VA AAPM 55 th Annual Meeting, Indianapolis,
More informationCarol Marquez, M.D. Department of Radiation Medicine OHSU
Carol Marquez, M.D. Department of Radiation Medicine OHSU Describe partial breast irradiation (PBI) and discuss why it is being used. Detail methods of performing partial breast irradiation. Explain how
More informationBreast Conservation Therapy
May 18, 2018 Breast Conservation Therapy One Treatment No Longer Fits All Presenter: Paul B. Fowler, MD Radiation Oncology, MGSH/MUMH 1 Objectives: 1. Define stages of breast cancer that are candidates
More informationpat hways Medtech innovation briefing Published: 24 August 2016 nice.org.uk/guidance/mib76
pat hways Axxent brachytherapy system for early stage breast cancer Medtech innovation briefing Published: 24 August 2016 nice.org.uk/guidance/mib76 Summary The technology described in this briefing is
More informationGUIDELINES FOR RADIOTHERAPY IN EARLY BREAST CANCER
GUIDELINES FOR RADIOTHERAPY IN EARLY BREAST CANCER Authors: Dr N Thorp/ Dr P Robson On behalf of the Breast CNG Written: Originally - December 2008 Reviewed: Updated - December 2011 Agreed: Breast TSG
More informationBREAST CANCER IOeRT RATIONALE
BREAST CANCER IOeRT RATIONALE Approximately 80% of the breast tumor recurrences origins at the site of the original disease. These data suggest that the majority of breast tumor recurrences result from
More informationCorporate Medical Policy
Corporate Medical Policy Intensity Modulated Radiation Therapy (IMRT) of the Chest File Name: Origination: Last CAP Review: Next CAP Review: Last Review: intensity_modulated_radiation_therapy_imrt_of_the_chest
More informationFirst results from the clinically controlled randomized DBCG PBI trial
First results from the clinically controlled randomized DBCG PBI trial BV Offersen 1, MS Thomsen 1, HM Nielsen 1, EH Jacobsen 2, M Berg 2, MH Nielsen 3, E Lorenzen 3, L Stenbygaard 4, I Jensen 4, AN Petersen
More informationGuidelines for the treatment of Breast cancer with radiotherapy v.1.0 September 2017
Guidelines for the treatment of Breast cancer with radiotherapy v.1.0 September 2017 Author: Dr Virginia Wolstenholme, Consultant Clinical Oncologist, Barts Health Date agreed: September 2017 Date to be
More informationBruno CUTULI Policlinico Courlancy REIMS. WORKSHOP SULL IRRADIAZIONE MAMMARIA IPOFRAZIONATA Il carcinoma duttale in situ
Bruno CUTULI Policlinico Courlancy REIMS WORKSHOP SULL IRRADIAZIONE MAMMARIA IPOFRAZIONATA Il carcinoma duttale in situ XXI CONGRESSO AIRO GENOVA 22.11.2011 INTRODUCTION Due to wide diffusion of mammography,
More informationTHE TRANSITION FROM 2D TO 3D AND TO IMRT - RATIONALE AND CRITICAL ELEMENTS
THE TRANSITION FROM 2D TO 3D AND TO IMRT - RATIONALE AND CRITICAL ELEMENTS ICTP SCHOOL ON MEDICAL PHYSICS FOR RADIATION THERAPY DOSIMETRY AND TREATMENT PLANNING FOR BASIC AND ADVANCED APPLICATIONS March
More informationTumour bed markers Kirby page 1. Tumour bed delineation for partial breast/ breast boost radiotherapy: what is the
Tumour bed markers Kirby page 1 Tumour bed delineation for partial breast/ breast boost radiotherapy: what is the optimal number of implanted markers? Kirby AM 1, Jena R 2, Harris EJ 3, Evans PM 3, Crowley
More informationRadiation Therapy for breast with Tomotherapy: When?
Radiation Therapy for breast with Tomotherapy: When? Roberto Orecchia Chair of Radiation Therapy at the University of Milan, IEO & CNAO Quarto incontro italo-francese sul carcinoma mammario: Problematiche
More informationBreast radiotherapy cardiac doses with MLC 1
Breast radiotherapy cardiac doses with MLC 1 Abstract Aims: To measure cardiac tissue doses in left-sided breast cancer patients receiving supine tangential field radiotherapy with multileaf collimation
More information7/28/2012. Hania Al-Hallaq, Ph.D. Assistant Professor Radiation Oncology The University of Chicago ***No disclosures***
Hania Al-Hallaq, Ph.D. Assistant Professor Radiation Oncology The University of Chicago ***No disclosures*** Review the clinical targets for breast RT as a function of cancer stage Learn about innovative
More informationSurgery for Breast Cancer
Surgery for Breast Cancer 1750 Mastectomy - Petit 1894 Radical mastectomy Halsted Extended, Super radical mastectomy 1948 Modified radical mastectomy Patey 1950-60 WLE & RT Baclesse, Mustakallio 1981-85
More information1. Screening, Diagnosis and Surgical Management of Breast Cancer
1. Screening, Diagnosis and Surgical Management of Breast Cancer Dr Melanie Walker, MBBS, FRACS (Breast Surgeon) Oncoplastic Breast Surgery Combination of optimal cancer surgery with plastic surgical techniques
More informationCorporate Medical Policy
Corporate Medical Policy Intensity Modulated Radiation Therapy (IMRT) of Head and Neck File Name: Origination: Last CAP Review: Next CAP Review: Last Review: intensity_modulated_radiation_therapy_imrt_of_head_and_neck
More informationPrinciples of breast radiation therapy
ANZ 1601/BIG 16-02 EXPERT ESMO Preceptorship Program 2017 Principles of breast radiation therapy Boon H Chua Professor Director of Cancer and Haematology Services UNSW Sydney and Prince of Wales Hospital
More informationLocally advanced disease & challenges in management
Gynecologic Cancer InterGroup Cervix Cancer Research Network Cervix Cancer Education Symposium, February 2018 Locally advanced disease & challenges in management Carien Creutzberg Radiation Oncology, Leiden
More informationAccelerated Radiation Treatment for Early Stage Breast Cancer. update and perspective
Accelerated Radiation Treatment for Early Stage Breast Cancer update and perspective School of Breast Oncology Atlanta, 11/2012 Douglas W. Arthur, M.D. Professor Traditional Whole Breast Irradiation WBI
More informationIORT What We ve Learned So Far
IORT What We ve Learned So Far The 16 th Annual Conference on A Multidisciplinary Approach to Comprehensive Breast Care and Imaging Einsley-Marie Janowski, MD, PhD Assistant Professor Department of Radiation
More informationClinical experience with TomoDirect System Tangential Mode
Breast Cancer Clinical experience with TomoDirect System Tangential Mode European Institute of Oncology Milan, Italy Disclosure & Disclaimer An honorarium is provided by Accuray for this presentation The
More informationAccelerated partial breast irradiation using external beam conformal radiation therapy: A review
Critical Reviews in Oncology/Hematology 81 (2012) 1 20 Accelerated partial breast irradiation using external beam conformal radiation therapy: A review Christopher F. Njeh a,, Mark W. Saunders a, Christian
More informationBy Rufus Mark, MD, Gail Lebovic, MD, Valerie Gorman, MD, Oscar Calvo, PhD. TABLE 1 EARLY STAGE BREAST CANCER RANDOMIZED TRIALS M vs.
EVOLUTION OF BREAST CONSERVATION RADIATION TREATMENT TECHNIQUES IN BREAST CANCER : FROM 6 WEEKS TO 3 WEEKS TO 1 WEEK TO 1 DAY AND FROM WHOLE BREAST TO PARTIAL BREAST By Rufus Mark, MD, Gail Lebovic, MD,
More informationRadiotherapy Management of Breast Cancer Treated with Neoadjuvant Chemotherapy. Julia White MD Professor, Radiation Oncology
Radiotherapy Management of Breast Cancer Treated with Neoadjuvant Chemotherapy Julia White MD Professor, Radiation Oncology Agenda Efficacy of radiotherapy in the management of breast cancer in the Adjuvant
More informationCURRICULUM OUTLINE FOR TRANSITIONING FROM 2-D RT TO 3-D CRT AND IMRT
CURRICULUM OUTLINE FOR TRANSITIONING FROM 2-D RT TO 3-D CRT AND IMRT Purpose The purpose of this curriculum outline is to provide a framework for multidisciplinary training for radiation oncologists, medical
More informationControversies in Breast Cancer
I Have Breast Cancer Now What? Katherine Gale FRACS Oncoplastic Breast Surgeon Controversies in Breast Cancer Katherine Gale FRACS Oncologic Controversies Margins in BCS Nipple Sparing Mastectomy:? Safe
More informationAdvances in Localized Breast Cancer
Advances in Localized Breast Cancer Melissa Camp, MD, MPH and Fariba Asrari, MD June 18, 2018 Moderated by Elissa Bantug 1 Advances in Surgery for Breast Cancer Melissa Camp, MD June 18, 2018 2 Historical
More informationElekta - a partner and world-leading supplier
Experience Elekta Elekta - a partner and world-leading supplier of clinical solutions for image guided radiation therapy, stereotactic radiotherapy, radiosurgery and brachytherapy, as well as advanced
More informationWhere are we with radiotherapy for biliary tract cancers?
Where are we with radiotherapy for biliary tract cancers? Professor Maria A. Hawkins Associate Professor in Clinical Oncology MRC Group Leader/Honorary Consultant Clinical Oncologist CRUK MRC Oxford Institute
More informationRadiation Therapy for Soft Tissue Sarcomas
Radiation Therapy for Soft Tissue Sarcomas Alexander R. Gottschalk, MD, PhD Assistant Professor, Radiation Oncology University of California, San Francisco 1/25/08 NCI: limb salvage vs. amputation 43 patients
More informationUCL. Rectum Adenocarcinoma. Quality of conformal radiotherapy Impact for the surgeon P. Scalliet & K. Haustermans
Rectum Adenocarcinoma Quality of conformal radiotherapy Impact for the surgeon P. Scalliet & K. Haustermans Fifth Belgian Surgical Week May 6th, 2004, Oostende SOR rectum adenocarcinoma Indication of radiotherapy
More informationAccelerated Partial Breast Irradiation: Potential Roles Following Breast-Conserving Surgery
APBI is a promising technique in selected patients with early-stage breast cancer, but further study is needed on outcome and toxicity associated with this approach. Nick Patten. Passing Light (detail).
More informationOverview of Advanced Techniques in Radiation Therapy
Overview of Advanced Techniques in Radiation Therapy Jacob (Jake) Van Dyk Manager, Physics & Engineering, LRCP Professor, UWO University of Western Ontario Acknowledgements Glenn Bauman Jerry Battista
More informationTecniche Radioterapiche U. Ricardi
Tecniche Radioterapiche U. Ricardi UNIVERSITA DEGLI STUDI DI TORINO Should we always rely on stage? T4N0M0 Stage IIIB T2N3M0 Early stage NSCLC The treatment of choice for early-stage NSCLC is anatomic
More informationBreast cancer. (early and advanced) Radiotherapy
Breast cancer (early and advanced) Radiotherapy Need for RT. ESTRO-HERO estimation Tumor site RT courses 2012 Increase in number 2025 Increase in rate (%) Breast 396,891 40,524 10.2 Lung 315,197 56,558
More informationBREAST CONSERVATION TREATMENT IN EARLY STAGE DISEASE AND DCIS LAWRENCE J. SOLIN, MD, FACR, FASTRO
BREAST CONSERVATION TREATMENT IN EARLY STAGE DISEASE AND DCIS LAWRENCE J. SOLIN, MD, FACR, FASTRO Chairman Department of Radiation Oncology Albert Einstein Medical Center Philadelphia, PA Professor (Adjunct)
More informationEpworth Radiation Oncology
Epworth HealthCare Epworth Radiation Oncology Intensity-Modulated Radiotherapy versus Three- Dimensional Conformal Radiotherapy; a retrospective study Emma Fitzgerald Overview Literature search into Breast
More informationRadiotherapy for Rectal Cancer. Kevin Palumbo Adelaide Radiotherapy Centre
Radiotherapy for Rectal Cancer Kevin Palumbo Adelaide Radiotherapy Centre Overview CRC are common (3 rd commonest cancer) rectal Ca approx 25-30% of all CRC. Presentation PR bleeding: beware attributing
More informationPurpose: To validate and compare the accuracy of breast tissue segmentation. methods applied to computed tomography (CT) scans used for radiotherapy
Purpose: To validate and compare the accuracy of breast tissue segmentation methods applied to computed tomography (CT) scans used for radiotherapy planning and to study the effect of tissue distribution
More informationBrachytherapy: The precise answer for tackling breast cancer. Because life is for living
Brachytherapy: The precise answer for tackling breast cancer Because life is for living Table of contents Executive summary 3 Introduction 4 Management of early stage breast cancer 5 Radiotherapy options
More informationRadiotherapy Considerations in Extremity Sarcoma
Radiotherapy Considerations in Extremity Sarcoma Peter Chung Department of Radiation Oncology Princess Margaret Hospital University of Toronto Role of RT in STS Local tumour eradication while allowing
More informationEvaluation of Monaco treatment planning system for hypofractionated stereotactic volumetric arc radiotherapy of multiple brain metastases
Evaluation of Monaco treatment planning system for hypofractionated stereotactic volumetric arc radiotherapy of multiple brain metastases CASE STUDY Institution: Odette Cancer Centre Location: Sunnybrook
More informationChapter 9 Radiotherapy A New Approach to Risk- Adapted Selective Radiotherapy
Chapter 9 Radiotherapy A New Approach to Risk- Adapted Selective Radiotherapy Csaba Polgár 9.1 Introduction During the last forty years, breast-conserving surgery (BCS) followed by whole breast irradiation
More informationEARLY STAGE BREAST CANCER AND THE EMERGING ROLE OF IORT
May 13, 2016 EARLY STAGE BREAST CANCER AND THE EMERGING ROLE OF IORT Presenter: Paul B. Fowler, MD Radiation Oncology, MGSH/MUMH 1 Objectives: 1. List treatment options for early stage breast cancer. 2.
More informationSurgical Advances in the Treatment of Breast Cancer. Laura Kruper, MD, MSCE Chief, Breast Surgery
Surgical Advances in the Treatment of Breast Cancer Laura Kruper, MD, MSCE Chief, Breast Surgery Nothing to disclose DISCLOSURE LESS IS MORE Radiation Lymph nodes Reconstruction Less is More! Radiation
More informationAdditional Questions for Review 2D & 3D
Additional Questions for Review 2D & 3D 1. For a 4-field box technique, which of the following will deliver the lowest dose to the femoral heads? a. 100 SSD, equal dmax dose to all fields b. 100 SSD, equal
More informationSAGITTILT PRONE BREAST SOLUTION
PRONE BREAST SOLUTION Radiation therapy of breast cancer in prone position is an increasingly used treatment technique. Several publications, also recent ones, prove the dosimetrical advantage of this
More informationOriginal Article. Teyyiba Kanwal, Muhammad Khalid, Syed Ijaz Hussain Shah, Khawar Nadeem
Original Article Treatment Planning Evaluation of Sliding Window and Multiple Static Segments Technique in Intensity Modulated Radiotherapy for Different Beam Directions Teyyiba Kanwal, Muhammad Khalid,
More informationIntroduction to clinical Radiotherapy
Introduction to clinical Radiotherapy Sarah Brothwood Radiotherapy Practice Educator Rosemere Cancer Centre Sarah.brothwood@lthtr.nhs.uk 01772 522694 Radiotherapy We have been able to see and document
More informationFuture Therapeutic Developments in Head and Neck Cancer
Future Therapeutic Developments in Head and Neck Cancer Professor Kevin Harrington Joint Head of Division of Radiotherapy and Imaging The Institute of Cancer Research/The Royal Marsden NIHR Biomedical
More informationClinical Trials of Proton Therapy for Breast Cancer. Andrew L. Chang, MD 張維安 Study Chair
Clinical Trials of Proton Therapy for Breast Cancer Andrew L. Chang, MD 張維安 Study Chair AndrewLChangMD@gmail.com Disclosure Proton Center Development Corporation Scripps San Diego Proton Therapy Center
More informationBREAST CONSERVATION TREATMENT IN EARLY STAGE DISEASE AND DCIS LAWRENCE J. SOLIN, MD, FACR, FASTRO
BREAST CONSERVATION TREATMENT IN EARLY STAGE DISEASE AND DCIS LAWRENCE J. SOLIN, MD, FACR, FASTRO Chairman Department of Radiation Oncology Albert Einstein Healthcare Network Philadelphia, PA Professor
More informationQuality assurance and credentialing requirements for sites using inverse planned IMRT Techniques
TROG 08.03 RAVES Quality assurance and credentialing requirements for sites using inverse planned IMRT Techniques Introduction Commissioning and quality assurance of planning systems and treatment delivery
More informationThe role of chemoradiotherapy in GE junction and gastric cancer. Karin Haustermans
The role of chemoradiotherapy in GE junction and gastric cancer Karin Haustermans Overview Postoperative chemoradiotherapy Preoperative chemoradiotherapy Palliative radiation Technical aspects Overview
More informationIntroduction of RapidArc TM : an example of commissioning and implementing a QA programme for a new technology
Introduction of RapidArc TM : an example of commissioning and implementing a QA programme for a new technology Philip Mayles Clatterbridge Centre for Oncology, Wirral, UK 1 What is RapidArc (or VMAT)?
More informationCardiovascular disease after radiation therapy
Cardiovascular disease after radiation therapy Giovanna Gagliardi Section of Radiotherapy Physics and Engineering Dept. of Medical Physics Karolinska University Hospital, Stockholm EU Scientific Seminar
More informationOptimal Management of Isolated HER2+ve Brain Metastases
Optimal Management of Isolated HER2+ve Brain Metastases Eliot Sims November 2013 Background Her2+ve patients 15% of all breast cancer Even with adjuvant trastuzumab 10-15% relapse Trastuzumab does not
More informationFEE RULES RADIATION ONCOLOGY FEE SCHEDULE CONTENTS
Tel: +27-21-9494060 Fax: +27-21-9494112 E-mail: leon.gouws@cancercare.co.za FEE RULES RADIATION ONCOLOGY FEE SCHEDULE CONTENTS 1. EXTERNAL BEAM RADIATION... 2 2. PLANNING OF TREATMENT... 2 3. DELIVERY
More informationRadiation Therapy: From Fallacy to Science
27 th Annual Management of Colon and Rectal Diseases 2.23.2019 Radiation Therapy: From Fallacy to Science Hadi Zahra, MD, DABR Radiation Oncologist CHI Health Henry Lynch Cancer Center Assistant Clinical
More information