Ioert To The Tumor Bed
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The document summarizes findings from a pooled analysis of 1200 patients treated with intraoperative radiotherapy (IORT) using electrons to deliver a 10 Gy boost to the tumor bed, followed by whole breast irradiation. Key findings included: 1. With a median follow-up of 59.6 months, the in-breast tumor control rate was 99.3% and 8 in-breast recurrences were observed. 2. Disease-free survival at 7 years was 87.7% and disease-specific survival was 94.5%. 3. True local recurrences accounted for 3 of the 8 in-breast recurrences, while the other 5 were out-of-quadrant recurrences.
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Palliative Radiotherapy Using Cone Beam Ct
This document describes a one-step model for online planning and treatment of palliative radiotherapy using cone beam CT (CBCT). In phase A, CBCT image quality was found to be adequate for treatment planning. Phase B involved online planning with CBCT for 45 patients, showing good agreement with conventional planning CT. Treatment plans were delivered in an average of 28 minutes from patient arrival. Phase C is ongoing to further test the efficacy of this one-step CBCT planning approach in reducing planning time and improving patient satisfaction compared to conventional multi-step planning CT.
Heidelberg Ion Therapy Center
The document discusses ion beam therapy and the Heidelberg Ion Therapy Center. Some key points:
1) The Heidelberg Ion Therapy Center will provide carbon and proton ion beam therapy using raster scanning technology for precise dose delivery.
2) Clinical studies are underway to evaluate the effectiveness of carbon ion therapy for various cancers and determine optimal treatment protocols.
3) The center is scheduled to treat its first patient in early 2009 and will have the capacity to treat over 1,000 patients per year.
Cancer Chemo Radiation Concurrent Supplements
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Tele Optometry (kunj'sppt) / Basics of tele optometry.
Ioert To The Tumor Bed
- 1. ISIORT Europe IOERT to the tumor bed, followed by whole breast irradiation: Update of the Pooled Analysis on the BIO-Boost Sedlmayer F, Fastner G, Merz F, Reitsamer R, Menzel C Salzburg / A Ciabattoni A, Petrucci A Rom SGF Neri / I Hagen E Klagenfurt / A Willich N, Schuck A, Brinkmann M Münster / D Orecchia R Mailand /I Valentini V Rom UC Gemelli/I
- 2. BIO-Boost: Linac-based IORT with Electrons 9-10 Gy IORT Boost + 50 Gy Whole-Breast
- 3. ISIORT Europe Breast Intraoperative Boost (BIO- Boost) : Pooled Analysis* 10/98 – 12/05: 1200 treatments Salzburg 870 SFN/Rom 142 Klagenfurt 74 Mailand 65 Münster 38 UC Gemelli/Rom 11 *4/07
- 4. Patients ISIORT BIO-Boost Pooled Analysis „ Best Selection“: T1-2 N0 G1-2, >50a: 331 Patients (30%) N-positive and/or G3 and/or T3 and/or Age<45a. 716 Pat. (60%) Age: 57,3 a (22,5 – 89,9) 62 29 21 n.st. 3 Gx 9 Nx 7 T3 284 G3 7 N3 295 T2 538 G2 32 N2 695 T1 143 G1 343 N1 5 T0 611 N0 8 Dcis Grading N T
- 15. Disease Free Survival (7a): N0: 93,2 % N1: 82,9 % N2: 69,1% T1 : 91,7 % T2 : 85 %
- 16. Follow-up 2/08: Disease Specific Survival (7a) 7 a: 94,8% (all)
- 17. Follow-up 4/07: Overall Survival (7a) 5 a: 95,6% 7 a: 91,5% (all)
- 18. Boost-RT for everybody ?
- 19. Effect of age and radiation dose on local control after breast conserving treatment: EORTC trial 22881-10882 Antonini N, …. Bartelink H Radiotherapy and Oncology 82 (2007) 265–271 Boost (16 Gy) versus No-Boost following WBRT with 50 Gy n = 5.318 Pat. Re-Analysis at 77,5 Mo med FU: Boost-advantage for all age groups
- 20. Spline Kurve for age and risk for developement of a local recurrence LN-Transformation function in terms of Hazard Risk ratios (5-a-steps) 1. Age-independent boost effect : halfened LR-Rates 2. Reduced absolute LR-Risk with growing age 3. Highest absolute gain at ages < 45 a
- 21. IOERT with 10 Gy has an iso-effect of at least 17 Gy in standard fractionation IOERT vs. postop. Boost Int J Cancer 2006 In-Breast Tumor Recurrence after 5 a: 4,3 vs. 0 % P < 0,01
- 23. Bio-Boost Milano/ELIOT Veronesi, Orecchia et al Ann Surg 2005
- 27. PATTERN OF LOCAL RECURRENCE AFTER CONSERVATIVE SURGERY AND WHOLE-BREAST IRRADIATION True local recurrence rates: 2%, 5%, and 7% (5–9%) at 5, 10, and 15 years, In-Breast-Recurrences „elsewhere“ : rare at 5 (1%) and 10 (2%) years, but increased to 6 (3–9%) at 15 years (same rates!) Different times to recurrence : Freedman et al, IJROBP 2005 1190 pts. IBTR „elsewhere“ is counterbalanced by HT, but: without WBRT ???