Subject Index
3D-CRT
RTOG 0319 101 3D conformal APBI 222
3D conformal APBI-supine position – The William Beaumont Hospital Experience 152
acute toxicity 156
beam arrangement 152, 154 cosmetic results 156 couch angles 153 CTV 152, 154 five-field technique 154 four-field technique 153 PBI technique 156 PTV 152, 154 simulation 152
3D conformal APBI Mass General Hospital 157
PTV 157 volumes 157
3D conformal external beam 258, 259 3D conformal external beam radiotherapy
(3D-CRT) 101 50-kV x-ray beam 259
abscess 132
accelerated partial breast irradiation (APBI) 91, 247
high dose-rate (HDR) brachytherapy 91 low dose-rate (LDR) brachytherapy 91 accelerated repopulation 58
accelerated therapy 57 accuracy 64
American Brachytherapy Society (ABS) 5, 208
American Society of Breast Surgeons (ASBS) 24, 208, 255
anisotropy 136, 137, 187 antimicrobial therapy 95 applicator 170
–
– – – – – – – – – –
– –
– –
ASBS registry trial 257
augmentation mammoplasty 113
balloon-to-skin separation 258
balloon breast brachytherapy applicator 129 balloon catheter system 3
balloon intracavitary catheter 122 balloon rupture 255
balloon symmetry 137
Barmherzige Schwestern Hospital 236 biological effective doses (BED) 248 biological equivalence 56
biologically equivalent dose (BED) 10, 56 borders of the excisional cavity 94
surgical clips 94
brachytherapy 197, 201, 202, 203, 204 103Pd 197, 202, 204
125I 197, 202, 203, 204 192Ir 197, 201, 202, 203, 204 electronic brachytherapy 203, 204 implants 197, 201, 202, 203 microbrachytherapy 202 radionuclides 197, 201, 202, 203 brachytherapy techniques 248 breast-conserving surgery 70
cosmesis 72 DCIS 70
local recurrence 70, 76 margin 70
metallic clips 72 oncoplastic 70 volume of resection 71
breast conservation therapy (BCT) 91 Brown University 215
catheter identification 184 chemotherapy 254 Christie Hospital 3, 229 clinical target volume (CTV) 31
CTV margins 35 –
– – – – – – –
– – – – – – –
–
Subject Index
clonogenic cells 58 closed placement 136 cobalt-60 230
conformal external beam 247 conformality index (CI) 190 conformance 137
cosmetic outcome 99, 170, 250 Harvard criteria 99 cosmetic results 146 CT-guided 80
CT-guided breast brachytherapy 120 CT-guided supine catheter insertion 119 CT guidance 81
CTV 158
D90 132 DCIS 209 delay 164
dose-fractionation schedules 56 dose homogeneity 58, 86
dose homogeneity index (DHI) 44, 45, 60, 86, 119, 132, 188, 248, 249, 250, 253, 254, 255
dose inhomogeneity 56, 60 dose prescription 98 dose volume histogram 86 dosimetric comparison 160
3D conformal APBI techniques 160 APBI 160
PBI (Partial Breast Irradiation) 160 WBI (Whole Breast Irradiation) 160 dosimetric guidelines 85
double-trouble 60 dual effect 165
edema 44, 45 electron beam 110 electrons 259 ELIOT 168
elliptical balloon 134, 137 elongation factor 190 elsewhere failure 19, 20 EORTC 235
European clinical trials 229 evaluation parameters 44, 48, 53
3D-CRT 53 MammoSite 48 Multicatheter 44 –
– – – –
– – –
extensive intraductal component (EIC) 59, 209
external beam APBI studies 145 external beam techniques 248
fat necrosis 59, 60, 61, 250, 252, 254, 257, 259 FDA Study 218
fiducial markers 95, 96 field defect 164 Florence 231
fractionation schedule/scheme 148, 149 alpha-beta ratio 148
Baillet et al 148
hypofractionated postoperative WBI 148 fraction size 3
freehand technique 112, 113
geographical miss 164
German–Austrian Multicentric Trial 236 GliaSite 131
Groupe Européen de Curiethérapie – European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) 229 Guy’s Hospital 3, 231
Ham applicator 55
HDR brachytherapy implants 92 afterloading needles 92 HDR Iridium-192 source 93 template-based 92, 93, 100 hemorrhage 255
high-dose-rate interstitial brachytherapy 3 high dose-rate (HDR) 249, 250, 252, 253 hot spot 188
hypofractionated adjuvant radiation treatment 143
beam arrangement 144
clinical target volume (CTV) 144 dose-volume constraints 144 planning target volume 144 hypofractionated radiation regimen 11 hypofractionated regimens 57 hypofractionated treatment 58 hypofractionation 57
image-guided prone catheter insertion 116 image guidance 80
IMRT 51 – – –
– – –
– – – –
Subject Index
index quadrant 164 infection 255 interstitial 248
interstitial brachytherapy 55, 109, 110, 124, 209, 247, 250, 251
interstitial brachytherapy alone 98 5-year local actuarial recurrence rate 98 elsewhere breast failure rate 98 interstitial breast brachytherapy 125 interstitial catheter-based implants 132 interstitial HDR brachytherapy 146 interstitial high dose-rate (HDR)
implants 146 interstitial implant 111
interstitial needle-based therapy 71 surgical considerations 71 Intrabeam 165
IntraBeam device 63 intracavitary 248 Intracavitary therapy 55 intraoperative electron 3
intraoperative partial breast irradiation 259 intraoperative radiation therapy (IORT) 73,
247
applicator (see Fig. 6.2) 74 Intrabeam 74
low-energy x-rays 74 mobile linear accelerators 73 radioprotection 74
surgical considerations 73, 74, 75 intraoperative radiotherapy 63 ipsilateral breast recurrence 36
elsewhere failure 36, 37 true recurrences 36 irradiation 191 Italy 231
late effects 58 lateral techniques 135
lateral trocar tunneling technique 122 LDR implants 63, 65, 92
iodine-125 seeds 92 template-guided 92 linear quadratic model 56 local recurrence 164 loss of heterozygosity 167
low-dose-rate interstitial brachytherapy 3 low dose-rate (LDR) 249, 250, 252 –
–
–
– – – – – –
– –
– –
low dose-rate (LDR) brachytherapy 105 lumpectomy cavity 158
magnetic resonance imaging (MRI) 8 MammoSite 3, 61, 71, 110, 122, 129, 131,
132, 135, 136, 217, 238, 247, 255, 258 balloon conformance 73
infection rates 139 metallic clips 72 registry database 218 scar entry technique 72 seroma formation 140 surgical considerations 72 toxicity 139
trocar 73
MammoSite RTS 101, 129
Manchester volume implant table 190 margins 164
Massachusetts General Hospital 216 mastectomy specimens data 32 mathematical model 167 mean central dose (MCD) 237 microenvironment 168 Milan III trial 8 Mobetron 165
multicenter randomized trial 172 multicentric 164
multicentric randomized APBI trial (GEC-ESTRO) 241
multifocal 164
multiple dwell positions 132, 134
National Institute of Oncology (NIO) 234 National Surgical Adjuvant Breast and Bowel
Project (NSABP) 10 necrosis 251
New York University 222 Ninewells Hospital Study 232 nominal standard dose (NSD) 58 non-conformance 46, 47, 48, 255 normal-tissue injury 3
normal tissue dose guidelines 154 CTV 156
heart and lung dose–volume histogram 154
ipsilateral breast volume 154 PTV 156
normal tissue toxicity 251 –
– – – – – – – –
– – – –
Subject Index
Novac7 165
NSABP B39/RTOG 0413 phase III randomized trial 208
NSABP B39/RTOG 0413 trial 101, 223
Ochsner Clinic 211 online image guidance 159
William Beaumont Hospital data 159 open lateral technique 135
operating room 165 Örebro Medical Centre 232 orthovoltage 3
overall treatment time 58
partial breast irradiation 165 partial breast target volume 144 patency check 194
pattern-of-care studies 2 patterns of Failure 36
phase I/II trial of prone 3D conformal APBI, New York University 149
beam arrangement 151 cosmetic results 151 CTV 151
dose–volume histogram 151 heart volume 151
ipsilateral breast volumes 151 isodose distributions 150 lung volume 151 PTV 150
supine position 151 phase III clinical trials 264
European Brachytherapy Breast Cancer GEC-ESTRO Working Group 264 National Surgical Adjuvant Breast and Bowel Project (NSABP) 264 Radiation Therapy Oncology Group (RTOG) 264
phase III prospective randomized trial 146 Christie Hospital, Manchester, UK 146 local recurrence 147
margin status 146
recurrence-free survival 146 phase III randomized study 160 phase III trials 12
pilot dose escalation study 149 treatment fields 149 –
– – – – – – – – – – – – –
– – – –
–
planning target volume (PTV) 119 post-implant CT scan 95, 98 prone 3D conformal APBI 147, 150
normal surrounding tissue dose 147 patient positioning 147
prone template 214 protons 198, 199, 200, 201 PTV 85, 158
pulsed dose-rate (PDR) 232
quadrantectomy 20 quality assurance 188 quality management 180
Radiation Therapy Oncology Group (RTOG) 4
Radiation Therapy Oncology Group (RTOG) Trial 95-17 107
radiobiological aspects of APBI 56 radiobiology 252
randomized phase III trial 146 Polgar et al 146
randomized study 2 randomized trials 168
re-excision pathologic margin data 34 concerns 35
real-time intraoperative ultrasound 96 recurrence-free survival 146
recurrence occurs 164 reproducibility 64 residual disease 165 residual tumor burden 58 Rhode Island Hospital 215
Royal Devon and Exeter Hospital 232 RTOG 0319 157, 223
RTOG 95-17 209, 217, 223 rupture rates 136 Rush University 220
saving 174
scar-entry technique (SET) 122, 135 selection criteria 208
sentinel node 170 seroma 47, 132, 255 SET 135
SET method 136 single dwell position 132 –
–
–
–
Subject Index
single fraction 165 skin distance 48
measurement 49 skin dose 44, 48, 136 skin spacing 137 soft X-rays 110 spherical balloon 134
St. Vincent’s Cancer Center 220 subcutaneous fibrosis 252
suboptimal balloon-to-skin spacing 255 surface topology 64
surgical clips 43
targeted intraoperative radiotherapy 167 TARGIT 167, 168, 172
technique 25
3D-CRT 25, 26, 79, 264 intraoperative radiotherapy 25 MammoSite 25, 26, 79, 264 multicatheter brachytherapy 25, 264 telangiectasias 252
template 116, 180
template-based implant 181 template-guidance 214 temporal immediacy 168
The American Brachytherapy Society (ABS) 24
therapeutic index 167
three-dimensional conformal external beam PBI 110
toxicities 99
Common Toxicity Criteria (CTC) version 2.0 99
toxicity end-points 250
treatment, targeted and tailored 174 treatment paradigm 17, 18 treatment planning time 193 treatment schedule 2
trocar tunneling technique 122 –
– – – –
–
Tufts-New England Medical Center (NEMC) 215, 219
tumor-bed boost 1 tumor bed 7
tumor control probability 60
ultrasound 113
ultrasound catheter insertion 115 University Hospital of Vienna 236 University Hospitals of Erlangen and
Leipzig 236
University of Kansas 216
University of Southern California Pilot Phase I Dose Escalation Trial 148
treatment techniques 148 University of Wisconsin 214 Uzsoki Hospital 229
V100 53, 189, 248, 253
V150 44, 48, 189, 248, 253, 254, 255 V200 44, 48, 248, 254
V50 44, 48, 53 V90 44, 48, 53
Virginia Commonwealth University 215 virtual simulation 96
virtual treatment plan 96 voids 187
volume 59
waiting lists 163
whole-breast irradiation 6
wide-volume breast brachytherapy 106 wide-volume interstitial brachytherapy 211 William Beaumont Hospital 214, 222 William Beaumont Hospital Data 156
cosmetic results 157 CTV 156
PTV 156 toxicity 157 –
–
– – – –
