In patients with a de novo diagnosis of breast cancer with synchronous distant metastases , surgery and radiotherapy result in considerably better locoregional tumor control .
An improvement in survival has not been consistently proven , but may exist in subgroups of patients .
Bei Patientinnen mit primärer Fernmetastasierung führt die lokale Beh and lung mittels Operation und/oder Strahlentherapie zur besseren lokalen Tumorkontrolle .
Aim The purpose of this work is to give practical guidelines for radiotherapy of locally advanced , inflammatory and metastatic breast cancer at first presentation .
ZusammenfassungZielZiel der Arbeit ist die Entwicklung von Praxis-Leitlinien zur Strahlentherapie des lokal fortgeschrittenen einschließlich des inflammatorischen Mammakarzinoms sowie zur lokalen Therapie bei synchroner Fernmetastasierung .
Ein Überlebensvorteil besteht wohl nicht , möglicherweise aber doch für einige Subgruppen der Patientinnen .
Delineation of target volumes and organs at risk in adjuvant radiotherapy of early breast cancer: National guidelines and contouring atlas by the Danish Breast Cancer Cooperative Group
Abstract During the past decade planning of adjuvant radiotherapy ( RT ) of early breast cancer has changed from two-dimensional ( 2D ) to 3D conformal techniques . In the planning computerised tomography ( CT ) scan both the targets for RT and the organs at risk ( OARs ) are visualised , enabling an increased focus on target dose coverage and homogeneity with only minimal dose to the OARs . To ensure uniform RT in the national prospect i ve trials of the Danish Breast Cancer Cooperative Group ( DBCG ) , a national consensus for the delineation of clinical target volumes ( CTVs ) and OARs was required . Material and methods . A CT scan of a breast cancer patient after surgical breast conservation and axillary lymph node ( LN ) dissection was used for delineation . During multiple dummy-runs seven experienced radiation oncologists contoured all CTVs and OARs of interest in adjuvant breast RT . Two meetings were held in the DBCG Radiotherapy Committee to discuss the contouring and to approve a final consensus . The Dice similarity coefficient ( DSC ) was used to evaluate the delineation agreement before and after the consensus . Results . The consensus delineations of CTVs and OARs are available online and a table is presented with a contouring description of the individual volumes . The consensus provides recommendations for target delineation in a st and ard patient both in case of breast conservation or mastectomy . Before the consensus , the average value of the DSC was modest for most volumes , but high for the breast CTV and the heart . After the consensus , the DSC increased for all volumes . Conclusion . The DBCG has provided the first national guidelines and a contouring atlas of CTVs and OARs definition for RT of early breast cancer . The DSC is a useful tool in quantifying the effect of the introduction of guidelines indicating improved inter-delineator agreement . This consensus will be used by the DBCG in our prospect i ve trials
In patients with a de novo diagnosis of breast cancer with synchronous distant metastases , surgery and radiotherapy result in considerably better locoregional tumor control .
An improvement in survival has not been consistently proven , but may exist in subgroups of patients .
Bei Patientinnen mit primärer Fernmetastasierung führt die lokale Beh and lung mittels Operation und/oder Strahlentherapie zur besseren lokalen Tumorkontrolle .
Aim The purpose of this work is to give practical guidelines for radiotherapy of locally advanced , inflammatory and metastatic breast cancer at first presentation .
ZusammenfassungZielZiel der Arbeit ist die Entwicklung von Praxis-Leitlinien zur Strahlentherapie des lokal fortgeschrittenen einschließlich des inflammatorischen Mammakarzinoms sowie zur lokalen Therapie bei synchroner Fernmetastasierung .
Ein Überlebensvorteil besteht wohl nicht , möglicherweise aber doch für einige Subgruppen der Patientinnen .