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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP-
dc.contributor.authorFREITAS, Thiago Brasileiro de-
dc.contributor.authorLIMA, Kennya Medeiros Lopes de Barros-
dc.contributor.authorCARVALHO, Heloisa de Andrade-
dc.contributor.authorMARQUES, Patricia de Azevedo-
dc.contributor.authorMATTOS, Fabio Teixeira Belfort-
dc.contributor.authorFONSECA, Alexandre Siqueira Franco-
dc.contributor.authorMUNHOZ, Alexandre Mendonca-
dc.contributor.authorFILASSI, Jose Roberto-
dc.contributor.authorSTUART, Silvia R.-
dc.contributor.authorMARTA, Gustavo Nader-
dc.identifier.citationEJSO, v.44, n.9, p.1312-1317, 2018-
dc.description.abstractPurpose/objective(s): To evaluate the role of surgical clips placement in the definition of boost treatment volume. Materials/methods: Clinical Target Volumes (CTV) were defined as: CTV Breast, CTV Quadrant (based on physical exam and pre-surgical images), CTV Boost, defined by clip plus margin (1 cm for 2 or more clips and 2 cm for 1 clip only) plus radiological changes, CTV NT (normal tissue), defined by CTV Quadrant minus CTV Boost and CTV MISS (CTV that would be outside the treatment volume), defined by cry Boost minus CTV Quadrant. Results: A total of 247 patients were included. Upper lateral quadrant was the most common clinical location (47.3%). The median number of clips used was three. The mean volumes were: CTV Breast:982.52 cc, CTV Boost:36.59 cc, CTV Quadrant:285.07 cc, Cry NT:210.1 cc and CTV MISS:13.57 cc. Only 50.6% (125) of the patients presented the CTV Boost completely inside the Cry Quadrant and in 473% (117), partially inside. Among patients with any CFV MISS, 803% (98) had 10% or more of CTV Boost outside the treatment volume. Regarding CTV MISS, there were no statistically significant differences between the groups with 1 clip versus 2 or more clips, nor between patients with or without reconstructive surgery. In average, the CTV Boost was 87% smaller than the CFV Quadrant. The whole quadrant irradiation would lead to unnecessary irradiation of 26% of normal breast tissue. Conclusion: Surgical bed clipping is up most important in the definition of the boost volume irradiation to ensure precision minimizing geographical miss and optimizing surrounding normal tissue sparing.-
dc.publisherELSEVIER SCI LTD-
dc.subjectBreast cancer-
dc.subjectRadiation therapy-
dc.subjectSurgical clips-
dc.subjectBreast conserving surgery-
dc.subject.othertumor bed-
dc.subject.otherreduction mammaplasty-
dc.subject.othersurgical clips-
dc.titleWhat a difference a clip makes! Analysis of boost volume definition in radiation therapy for conservative breast surgery-
dc.rights.holderCopyright ELSEVIER SCI LTD-
dc.type.categoryoriginal article-
dc.type.versionpublishedVersion-, Patricia de Azevedo:Univ Sao Paulo, Fac Med, Canc Inst Sao Paulo, Dept Plast Surg,Div Breast Reconstruct, Sao Paulo, Brazil-
hcfmusp.relation.referenceBartelink H, 2001, NEW ENGL J MED, V345, P1378, DOI 10.1056/NEJMoa010874-
hcfmusp.relation.referenceBartelink H, 2007, J CLIN ONCOL, V25, P3259, DOI 10.1200/JCO.2007.11.4991-
hcfmusp.relation.referenceBEDWINEK J, 1993, INT J RADIAT ONCOL, V26, P675, DOI 10.1016/0360-3016(93)90287-6-
hcfmusp.relation.referenceBenda RK, 2003, CANCER, V97, P905, DOI 10.1002/cncr.11142-
hcfmusp.relation.referenceDavies C, 2011, LANCET, V378, P771, DOI 10.1016/S0140-6736(11)60993-8-
hcfmusp.relation.referenceGoldberg H, 2005, INT J RADIAT ONCOL, V63, P209, DOI 10.1016/j.ijrobp.2005.01.044-
hcfmusp.relation.referenceHepel JT, 2009, INT J RADIAT ONCOL, V74, P458, DOI 10.1016/j.ijrobp.2008.08.051-
hcfmusp.relation.referenceKirova YM, 2008, INT J RADIAT ONCOL, V72, P494, DOI 10.1016/j.ijrobp.2007.12.059-
hcfmusp.relation.referenceKirova YM, 2010, INT J RADIAT ONCOL, V78, P1352, DOI 10.1016/j.ijrobp.2009.10.049-
hcfmusp.relation.referenceLandis DM, 2007, INT J RADIAT ONCOL, V67, P1299, DOI 10.1016/j.ijrobp.2006.11.026-
hcfmusp.relation.referenceLANDIS JR, 1977, BIOMETRICS, V33, P159, DOI 10.2307/2529310-
hcfmusp.relation.referenceMACHTAY M, 1994, INT J RADIAT ONCOL, V30, P43, DOI 10.1016/0360-3016(94)90517-7-
hcfmusp.relation.referenceMunhoz AM, 2008, PLAST RECONSTR SURG, V121, P716, DOI 10.1097/01.prs.0000299295.74100.fa-
hcfmusp.relation.referenceMunhoz AM, 2006, ANN PLAS SURG, V57, P502, DOI 10.1097/
hcfmusp.relation.referenceMunhoz AM, 2014, WORLD J CLIN ONCOL, V5, P1, DOI 10.5306/wjco.v5.i1.1-
hcfmusp.relation.referenceMunhoz AM, 2006, PLAST RECONSTR SURG, V117, P1091, DOI 10.1097/01.prs.0000202121.84583.0d-
hcfmusp.relation.referencePoortmans P, 2012, SEMIN RADIAT ONCOL, V22, P29, DOI 10.1016/j.semradonc.2011.09.007-
hcfmusp.relation.referenceRomestaing P, 1997, J CLIN ONCOL, V15, P963, DOI 10.1200/JCO.1997.15.3.963-
hcfmusp.relation.referenceSOLIN LJ, 1985, INT J RADIAT ONCOL, V11, P1215, DOI 10.1016/0360-3016(85)90072-0-
hcfmusp.relation.referenceThe Radiation Therapy Oncology Group (RTOG), BREAST CANC ATL RAD-
hcfmusp.relation.referenceTorre LA, 2015, CA-CANCER J CLIN, V65, P87, DOI 10.3322/caac.21262-
Appears in Collections:

Artigos e Materiais de Revistas Científicas - FM/MDR
Departamento de Radiologia - FM/MDR

Artigos e Materiais de Revistas Científicas - HC/ICESP
Instituto do Câncer do Estado de São Paulo - HC/ICESP

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - HC/InRad
Instituto de Radiologia - HC/InRad

Artigos e Materiais de Revistas Científicas - LIM/04
LIM/04 - Laboratório de Microcirurgia

Artigos e Materiais de Revistas Científicas - ODS/03
ODS/03 - Saúde e bem-estar

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