Whole breast external beam radiotherapy is an effective adjuvant treatment for early breast cancer, and was a key factor in the move from mastectomy to breast-conserving surgery for women with low-risk disease. The lo...Whole breast external beam radiotherapy is an effective adjuvant treatment for early breast cancer, and was a key factor in the move from mastectomy to breast-conserving surgery for women with low-risk disease. The logical development from partial surgical removal of the breast is partial breast radiotherapy. Several methods of delivery have been investigated, but as yet none has been widely accepted.展开更多
After the results obtained in the two randomized clinical trial, the ELIOT trial and the TARGIT-A trial, a heated debate is going on concerning the question of applying intraoperative radiotherapy （IORT） instead of ...After the results obtained in the two randomized clinical trial, the ELIOT trial and the TARGIT-A trial, a heated debate is going on concerning the question of applying intraoperative radiotherapy （IORT） instead of postoperative whole breast irradiation （WBI） after breast conservative treatment. Currently, many centers are applying the IORT following the strict selection criteria dictated by the working groups American Society for Radiation Ontology （ASTRO） and Groupe Europeen de Curietherapie-European Society for Therapeutic Radiology and Oncology （GEC-ESTRO） and monitoring the oncological outcome together with radiation toxicity on breast tissue. The clinical experience of the Geneva University Hospital regarding the use of the Intrabeam system is evaluated and compared with current evidences.展开更多
The aim of this work was to evaluate and compare the performance of comparatively new synthetic PTW 60019 microDiamond with PTW 60017 Diode E detector in measuring the output factors (OF) of IntraOperative Radiation T...The aim of this work was to evaluate and compare the performance of comparatively new synthetic PTW 60019 microDiamond with PTW 60017 Diode E detector in measuring the output factors (OF) of IntraOperative Radiation Therapy (IORT) electron beams. For a given electron beam, OFs are defined as the ratio of the dose for any applicator size at the depth of maximum to that for a reference applicator. IORT is an innovative treatment technique that delivers a large single fraction of radiation dose to the tumor bed during surgery. The electron beams considered in this study were generated by the mobile NOVAC7 system. This device produces high-dose-per-pulse electron beams with four different energies in the range from 3 MeV to 9 MeV. We performed measurements for two higher energies, namely 7MeV and 9 MeV. The beam collimation was performed through Perspex (PMMA) cylindrical applicators with different diameters. The accurate dose delivery of IORT tightly depends on the precision of measured dose by reference applicator and the output factors of clinical applicators. The output factors were measured using microDiamond and Diode E detectors. The microDiamond detector performance was compared with a Diode E detector. Determined output factors of two detectors were in good agreement. The maximum deviations of output factors for microDiamond were found 2.74%, and 2.17% for 7 MeV and 9 MeV, respectively with respect to the PTW Diode E. The microDiamond detector was shown to exhibit excellent properties for output factor measurements and could be considered as a suitable tool for electron beam dosimetry.展开更多
BACKGROUND In recent years,intraoperative radiotherapy(IORT)has been increasingly used for the treatment of rectal cancer.However,the efficacy and safety of IORT for the treatment of rectal cancer are still controvers...BACKGROUND In recent years,intraoperative radiotherapy(IORT)has been increasingly used for the treatment of rectal cancer.However,the efficacy and safety of IORT for the treatment of rectal cancer are still controversial.AIM To evaluate the value of IORT for patients with rectal cancer.METHODS We searched PubMed,Embase,Cochrane Library,Web of Science databases,and conference abstracts and included randomized controlled trials and observational studies on IORT vs non-IORT for rectal cancer.Dichotomous variables were evaluated by odds ratio(OR)and 95%confidence interval(CI),hazard ratio(HR)and 95%CI was used as a summary statistic of survival outcomes.Statistical analyses were performed using Stata V.15.0 and Review Manager 5.3 software.RESULTS In this study,3 randomized controlled studies and 12 observational studies were included with a total of 1460 patients,who are mainly residents of Europe,the United States,and Asia.Our results did not show significant differences in 5-year overall survival(HR=0.80,95%CI=0.60-1.06;P=0.126);5-year disease-free survival(HR=0.94,95%CI=0.73-1.22;P=0.650);abscess(OR=1.10,95%CI=0.67-1.80;P=0.713),fistulae(OR=0.79,95%CI=0.33-1.89;P=0.600);wound complication(OR=1.21,95%CI=0.62-2.36;P=0.575);anastomotic leakage(OR=1.09,95%CI=0.59-2.02;P=0.775);and neurogenic bladder dysfunction(OR=0.69,95%CI=0.31-1.55;P=0.369).However,the meta-analysis of 5-year local control was significantly different(OR=3.07,95%CI=1.66-5.66;P=0.000).CONCLUSION The advantage of IORT is mainly reflected in 5-year local control,but it is not statistically significant for 5-year overall survival,5-year disease-free survival,and complications.展开更多
Whole breast irradiation after breast-conserving surgery for early breast cancer has become one of the standard treatment modes for breast cancer and yields the same effect as radical surgery.Accelerated partial breas...Whole breast irradiation after breast-conserving surgery for early breast cancer has become one of the standard treatment modes for breast cancer and yields the same effect as radical surgery.Accelerated partial breast irradiation(APBI)as a substitute for whole breast irradiation for patients with early breast cancer is a hot spot in clinical research.APBI is characterised by simple high-dose local irradiation of the tumour bed in a short time,thus improving convenience for patients and saving costs.The implementation methods of APBI mainly include brachytherapy,external beam radiation therapy,and intraoperative radiotherapy.This review provides an overview of the clinical effects and adverse reactions of the main technologies of APBI and discusses the prospects for the future development of APBI.展开更多
文摘Whole breast external beam radiotherapy is an effective adjuvant treatment for early breast cancer, and was a key factor in the move from mastectomy to breast-conserving surgery for women with low-risk disease. The logical development from partial surgical removal of the breast is partial breast radiotherapy. Several methods of delivery have been investigated, but as yet none has been widely accepted.
文摘After the results obtained in the two randomized clinical trial, the ELIOT trial and the TARGIT-A trial, a heated debate is going on concerning the question of applying intraoperative radiotherapy （IORT） instead of postoperative whole breast irradiation （WBI） after breast conservative treatment. Currently, many centers are applying the IORT following the strict selection criteria dictated by the working groups American Society for Radiation Ontology （ASTRO） and Groupe Europeen de Curietherapie-European Society for Therapeutic Radiology and Oncology （GEC-ESTRO） and monitoring the oncological outcome together with radiation toxicity on breast tissue. The clinical experience of the Geneva University Hospital regarding the use of the Intrabeam system is evaluated and compared with current evidences.
文摘The aim of this work was to evaluate and compare the performance of comparatively new synthetic PTW 60019 microDiamond with PTW 60017 Diode E detector in measuring the output factors (OF) of IntraOperative Radiation Therapy (IORT) electron beams. For a given electron beam, OFs are defined as the ratio of the dose for any applicator size at the depth of maximum to that for a reference applicator. IORT is an innovative treatment technique that delivers a large single fraction of radiation dose to the tumor bed during surgery. The electron beams considered in this study were generated by the mobile NOVAC7 system. This device produces high-dose-per-pulse electron beams with four different energies in the range from 3 MeV to 9 MeV. We performed measurements for two higher energies, namely 7MeV and 9 MeV. The beam collimation was performed through Perspex (PMMA) cylindrical applicators with different diameters. The accurate dose delivery of IORT tightly depends on the precision of measured dose by reference applicator and the output factors of clinical applicators. The output factors were measured using microDiamond and Diode E detectors. The microDiamond detector performance was compared with a Diode E detector. Determined output factors of two detectors were in good agreement. The maximum deviations of output factors for microDiamond were found 2.74%, and 2.17% for 7 MeV and 9 MeV, respectively with respect to the PTW Diode E. The microDiamond detector was shown to exhibit excellent properties for output factor measurements and could be considered as a suitable tool for electron beam dosimetry.
基金Supported by Natural Science Foundation of Gansu Province,China,No.18JR3RA052Gansu Province Da Vinci robot high end diagnosis and treatment personnel training project+2 种基金National Key Research and Development Program Task Book,No.2018YFC1311506Lanzhou Talent Innovation and Entrepreneurship Project Task Contract,No.2016-RC-562019 Graduate Innovation Fund Project,No.2020CX50.
文摘BACKGROUND In recent years,intraoperative radiotherapy(IORT)has been increasingly used for the treatment of rectal cancer.However,the efficacy and safety of IORT for the treatment of rectal cancer are still controversial.AIM To evaluate the value of IORT for patients with rectal cancer.METHODS We searched PubMed,Embase,Cochrane Library,Web of Science databases,and conference abstracts and included randomized controlled trials and observational studies on IORT vs non-IORT for rectal cancer.Dichotomous variables were evaluated by odds ratio(OR)and 95%confidence interval(CI),hazard ratio(HR)and 95%CI was used as a summary statistic of survival outcomes.Statistical analyses were performed using Stata V.15.0 and Review Manager 5.3 software.RESULTS In this study,3 randomized controlled studies and 12 observational studies were included with a total of 1460 patients,who are mainly residents of Europe,the United States,and Asia.Our results did not show significant differences in 5-year overall survival(HR=0.80,95%CI=0.60-1.06;P=0.126);5-year disease-free survival(HR=0.94,95%CI=0.73-1.22;P=0.650);abscess(OR=1.10,95%CI=0.67-1.80;P=0.713),fistulae(OR=0.79,95%CI=0.33-1.89;P=0.600);wound complication(OR=1.21,95%CI=0.62-2.36;P=0.575);anastomotic leakage(OR=1.09,95%CI=0.59-2.02;P=0.775);and neurogenic bladder dysfunction(OR=0.69,95%CI=0.31-1.55;P=0.369).However,the meta-analysis of 5-year local control was significantly different(OR=3.07,95%CI=1.66-5.66;P=0.000).CONCLUSION The advantage of IORT is mainly reflected in 5-year local control,but it is not statistically significant for 5-year overall survival,5-year disease-free survival,and complications.
文摘Whole breast irradiation after breast-conserving surgery for early breast cancer has become one of the standard treatment modes for breast cancer and yields the same effect as radical surgery.Accelerated partial breast irradiation(APBI)as a substitute for whole breast irradiation for patients with early breast cancer is a hot spot in clinical research.APBI is characterised by simple high-dose local irradiation of the tumour bed in a short time,thus improving convenience for patients and saving costs.The implementation methods of APBI mainly include brachytherapy,external beam radiation therapy,and intraoperative radiotherapy.This review provides an overview of the clinical effects and adverse reactions of the main technologies of APBI and discusses the prospects for the future development of APBI.
