What a difference a clip makes! Analysis of boost volume definition in radiation therapy for conservative breast surgery

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author FREITAS, Thiago Brasileiro de FMUSP-HC
LIMA, Kennya Medeiros Lopes de Barros FMUSP-HC
CARVALHO, Heloisa de Andrade FMUSP-HC
MARQUES, Patricia de Azevedo
MATTOS, Fabio Teixeira Belfort FMUSP-HC
FONSECA, Alexandre Siqueira Franco FMUSP-HC
MUNHOZ, Alexandre Mendonca FMUSP-HC
FILASSI, Jose Roberto FMUSP-HC
STUART, Silvia R. FMUSP-HC
MARTA, Gustavo Nader FMUSP-HC
dc.date.issued 2018
dc.identifier.citation EJSO, v.44, n.9, p.1312-1317, 2018
dc.identifier.issn 0748-7983
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/29428
dc.description.abstract Purpose/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.language.iso eng
dc.publisher ELSEVIER SCI LTD
dc.relation.ispartof Ejso
dc.rights restrictedAccess
dc.subject Breast cancer; Radiation therapy; Boost; Surgical clips; Breast conserving surgery
dc.subject.other tumor bed; reduction mammaplasty; surgical clips; cancer; reconstruction; radiotherapy; irradiation; cavity; trial
dc.title What a difference a clip makes! Analysis of boost volume definition in radiation therapy for conservative breast surgery
dc.type article
dc.rights.holder Copyright ELSEVIER SCI LTD
dc.description.group LIM/04
dc.identifier.doi 10.1016/j.ejso.2018.06.010
dc.identifier.pmid 30041975
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author FREITAS, Thiago Brasileiro de:HC:INRAD
hcfmusp.author LIMA, Kennya Medeiros Lopes de Barros:HC:INRAD
hcfmusp.author CARVALHO, Heloisa de Andrade:FM:MDR
hcfmusp.author MATTOS, Fabio Teixeira Belfort:HC:ICHC
hcfmusp.author FONSECA, Alexandre Siqueira Franco:HC:ICESP
hcfmusp.author MUNHOZ, Alexandre Mendonca:HC:ICESP
hcfmusp.author FILASSI, Jose Roberto:HC:ICESP
hcfmusp.author STUART, Silvia R.:HC:INRAD
hcfmusp.author MARTA, Gustavo Nader:HC:ICESP
hcfmusp.author.external · MARQUES, Patricia de Azevedo:Univ Sao Paulo, Fac Med, Canc Inst Sao Paulo, Dept Plast Surg,Div Breast Reconstruct, Sao Paulo, Brazil
hcfmusp.origem.id WOS:000444356500006
hcfmusp.origem.id 2-s2.0-85049310984
hcfmusp.publisher.city OXFORD
hcfmusp.publisher.country ENGLAND
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dc.description.index MEDLINE
dc.identifier.eissn 1532-2157
hcfmusp.citation.scopus 4
hcfmusp.affiliation.country Brasil
hcfmusp.scopus.lastupdate 2021-07-13


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