DOI QR코드

DOI QR Code

Tumor bed volumetric changes during breast irradiation for the patients with breast cancer

  • Chung, Mi Joo (Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine) ;
  • Suh, Young Jin (Department of Surgery, St. Vincent's Hospital, The Catholic University of Korea College of Medicine) ;
  • Lee, Hyo Chun (Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine) ;
  • Kang, Dae Gyu (Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine) ;
  • Kim, Eun Joong (Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine) ;
  • Kim, Sung Hwan (Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine) ;
  • Lee, Jong Hoon (Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine)
  • 투고 : 2013.07.10
  • 심사 : 2013.10.07
  • 발행 : 2013.12.31

초록

Purpose: The aim of this study was to evaluate changes in breast tumor bed volume during whole breast irradiation (WBI). Materials and Methods: From September 2011 to November 2012, thirty patients who underwent breast-conserving surgery (BCS) followed by WBI using computed tomography (CT) simulation were enrolled. Simulation CT scans were performed before WBI (CT1) and five weeks after the breast irradiation (CT2). The tumor bed was contoured based on surgical clips, seroma, and postoperative change. We retrospectively analyzed the factors associated with tumor bed volumetric change. Results: The median tumor bed volume on CT1 and CT2 was 29.72 and 28.6 mL, respectively. The tumor bed volume increased in 9 of 30 patients (30%) and decreased in 21 of 30 patients (70%). The median percent change in tumor bed volume between initial and boost CT was -5%. Seroma status (p = 0.010) was a significant factor in tumor bed volume reduction of 5% or greater. However, patient age, body mass index, palpability, T stage, axillary lymph node dissection, and tumor location were not significant factors for tumor bed volumetric change. Conclusion: In this study, volumetric change of tumor bed cavity was frequent. Patients with seroma after BCS had a significant volume reduction of 5% or greater in tumor bed during breast irradiation. Thus, resimulation using CT is indicated for exquisite boost treatment in breast cancer patients with seroma after surgery.

키워드

참고문헌

  1. Christian MC, McCabe MS, Korn EL, Abrams JS, Kaplan RS, Friedman MA. The National Cancer Institute audit of the National Surgical Adjuvant Breast and Bowel Project Protocol B-06. N Engl J Med 1995;333:1469-74. https://doi.org/10.1056/NEJM199511303332206
  2. Clarke M, Collins R, Darby S, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 2005;366:2087-106. https://doi.org/10.1016/S0140-6736(05)67887-7
  3. Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 2005;365:1687-717. https://doi.org/10.1016/S0140-6736(05)66544-0
  4. Vicini FA, Antonucci JV, Goldstein N, et al. The use of molecular assays to establish definitively the clonality of ipsilateral breast tumor recurrences and patterns of in-breast failure in patients with early-stage breast cancer treated with breast-conserving therapy. Cancer 2007;109:1264-72. https://doi.org/10.1002/cncr.22529
  5. Kurtz JM, Amalric R, Brandone H, et al. Local recurrence after breast-conserving surgery and radiotherapy: frequency, time course, and prognosis. Cancer 1989;63:1912-7. https://doi.org/10.1002/1097-0142(19890515)63:10<1912::AID-CNCR2820631007>3.0.CO;2-Y
  6. Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 2002;347:1233-41. https://doi.org/10.1056/NEJMoa022152
  7. Gage I, Recht A, Gelman R, et al. Long-term outcome following breast-conserving surgery and radiation therapy. Int J Radiat Oncol Biol Phys 1995;33:245-51. https://doi.org/10.1016/0360-3016(95)02001-R
  8. Romestaing P, Lehingue Y, Carrie C, et al. Role of a 10-Gy boost in the conservative treatment of early breast cancer: results of a randomized clinical trial in Lyon, France. J Clin Oncol 1997;15:963-8.
  9. Prendergast B, Indelicato DJ, Grobmyer SR, et al. The dynamic tumor bed: volumetric changes in the lumpectomy cavity during breast-conserving therapy. Int J Radiat Oncol Biol Phys 2009;74:695-701. https://doi.org/10.1016/j.ijrobp.2008.08.044
  10. Flannery TW, Nichols EM, Cheston SB, et al. Repeat computed tomography simulation to assess lumpectomy cavity volume during whole-breast irradiation. Int J Radiat Oncol Biol Phys 2009;75:751-6. https://doi.org/10.1016/j.ijrobp.2008.11.024
  11. Hurkmans C, Admiraal M, van der Sangen M, Dijkmans I. Significance of breast boost volume changes during radiotherapy in relation to current clinical interobserver variations. Radiother Oncol 2009;90:60-5. https://doi.org/10.1016/j.radonc.2007.12.001
  12. Oh KS, Kong FM, Griffith KA, Yanke B, Pierce LJ. Planning the breast tumor bed boost: changes in the excision cavity volume and surgical scar location after breast-conserving surgery and whole-breast irradiation. Int J Radiat Oncol Biol Phys 2006;66:680-6. https://doi.org/10.1016/j.ijrobp.2006.04.042
  13. Li XA, Tai A. Arthur DW, et al. Variability of target and normal structure delineation for breast cancer radiotherapy: an RTOG Multi-Institutional and Multiobserver Study. Int J Radiat Oncol Bioi Phys 2009;73:944-51. https://doi.org/10.1016/j.ijrobp.2008.10.034
  14. National Surgical Adjuvant Breast and Bowel Project; Radiation Therapy Oncology Group. NSABP B-39, RTOG 0413: a randomized phase III study of conventional whole breast irradiation versus partial breast irradiation for women with stage 0, I, or ll breast cancer. Clin Adv Hematol Oncol 2006;4:719-21.
  15. Machtay M, Lanciano R, Hoffman J, Hanks GE. Inaccuracies in using the lumpectomy scar for planning electron boosts in primary breast carcinoma. Int J Radiat Oncol Biol Phys 1994;30:43-8. https://doi.org/10.1016/0360-3016(94)90517-7
  16. Oh KS, Kong FM, Griffith KA. Yanke B, Pierce LJ. Planning the breast tumor bed boost: changes in the excision cavity volume and surgical scar location after breast-conserving surgery and whole-breast irradiation. Int J Radiat Oncol Biol Phys 2006;66:680-6. https://doi.org/10.1016/j.ijrobp.2006.04.042
  17. Huh SJ, Han Y, Park W, Yang JH. Interfractional dose variation due to seromas in radiotherapy of breast cancer. Med Dosim 2005;30:8-11. https://doi.org/10.1016/j.meddos.2004.10.002
  18. Cho H, Kim C. Volumetric changes in the lumpectomy cavity during whole breast irradiation after breast conserving surgery. Radiat Oncol J 2011;29:277-82. https://doi.org/10.3857/roj.2011.29.4.277
  19. Srivastava V, Basu S, Shukla VK. Seroma formation after breast cancer surgery: what we have learned in the last two decades. J Breast Cancer 2012;15:373-80. https://doi.org/10.4048/jbc.2012.15.4.373
  20. Okada N, Narita Y, Takada M, et al. Early removal of drains and the incidence of seroma after breast surgery. Breast Cancer 2013 Mar 14 [Epub]. http://dx.doi.org/l0.1007/s12282-013- 0457-3.
  21. McCormick B, Yahalom J, Cox L, Shank B, Massie MJ. The patients perception of her breast following radiation and limited surgery. Int J Radiat Oncol Biol Phys 1989;17:1299-302. https://doi.org/10.1016/0360-3016(89)90540-3
  22. Giuliano AE, Hunt KK, Ballman KV, et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA 2011;305:569-75. https://doi.org/10.1001/jama.2011.90
  23. Land SR, Kopec JA, Julian TB, et al. Patient-reported outcomes in sentinel node-negative adjuvant breast cancer patients receiving sentinel-node biopsy or axillary dissection: National Surgical Adjuvant Breast and Bowel Project phase III protocol B-32. J Clin Oncol 2010;28:3929-36. https://doi.org/10.1200/JCO.2010.28.2491

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