Selection criteria for early breast cancer patients in the DBCG proton trial - The randomised phase III trial strategy
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Selection criteria for early breast cancer patients in the DBCG proton trial - The randomised phase III trial strategy. / Stick, Line Bjerregaard; Lorenzen, Ebbe Laugaard; Yates, Esben Svitzer; Anandadas, Carmel; Andersen, Karen; Aristei, Cynthia; Byrne, Orla; Hol, Sandra; Jensen, Ingelise; Kirby, Anna M.; Kirova, Youlia M.; Marrazzo, Livia; Matias-Perez, Angela; Nielsen, Mette Marie Bruun; Nissen, Henrik Dahl; Oliveros, Sileida; Verhoeven, Karolien; Vikstrom, Johan; Offersen, Birgitte Vrou.
I: Clinical and Translational Radiation Oncology, Bind 27, 03.2021, s. 126-131.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Selection criteria for early breast cancer patients in the DBCG proton trial - The randomised phase III trial strategy
AU - Stick, Line Bjerregaard
AU - Lorenzen, Ebbe Laugaard
AU - Yates, Esben Svitzer
AU - Anandadas, Carmel
AU - Andersen, Karen
AU - Aristei, Cynthia
AU - Byrne, Orla
AU - Hol, Sandra
AU - Jensen, Ingelise
AU - Kirby, Anna M.
AU - Kirova, Youlia M.
AU - Marrazzo, Livia
AU - Matias-Perez, Angela
AU - Nielsen, Mette Marie Bruun
AU - Nissen, Henrik Dahl
AU - Oliveros, Sileida
AU - Verhoeven, Karolien
AU - Vikstrom, Johan
AU - Offersen, Birgitte Vrou
PY - 2021/3
Y1 - 2021/3
N2 - Background and purpose: Adjuvant radiotherapy of internal mammary nodes (IMN) improves survival in high-risk early breast cancer patients but inevitably leads to more dose to heart and lung. Target coverage is often compromised to meet heart/lung dose constraints. We estimate heart and lung dose when target coverage is not compromised in consecutive patients. These estimates are used to guide the choice of selection criteria for the randomised Danish Breast Cancer Group (DBCG) Proton Trial.Materials and methods: 179 breast cancer patients already treated with loco-regional IMN radiotherapy from 18 European departments were included. If the clinically delivered treatment plan did not comply with defined target coverage requirements, the plan was modified retrospectively until sufficient coverage was reached. The choice of selection criteria was based on the estimated number of eligible patients for different heart and lung dose thresholds in combination with proton therapy capacity limitations and dose-response relationships for heart and lung.Results: Median mean heart dose was 3.0 Gy (range, 1.1-8.2 Gy) for left-sided and 1.4 Gy (0.4-11.5 Gy) for right-sided treatment plans. Median V17Gy/V20Gy (hypofractionated/normofractionated plans) for ipsilateral lung was 31% (9-57%). The DBCG Radiotherapy Committee chose mean heart dose > 4 Gy and/or lung V17Gy/V20Gy >= 37% as thresholds for inclusion in the randomised trial. Using thesethresholds, we estimate that 22% of patients requiring loco-regional IMN radiotherapy will be eligible for the trial.Conclusion: The patient selection criteria for the DBCG Proton Trial are mean heart dose >= 4 Gy and/or lung V17Gy/V20Gy >= 37%. (C) 2021 The Author(s). Published by Elsevier B.V. on behalf of European Society for Radiotherapy and Oncology.
AB - Background and purpose: Adjuvant radiotherapy of internal mammary nodes (IMN) improves survival in high-risk early breast cancer patients but inevitably leads to more dose to heart and lung. Target coverage is often compromised to meet heart/lung dose constraints. We estimate heart and lung dose when target coverage is not compromised in consecutive patients. These estimates are used to guide the choice of selection criteria for the randomised Danish Breast Cancer Group (DBCG) Proton Trial.Materials and methods: 179 breast cancer patients already treated with loco-regional IMN radiotherapy from 18 European departments were included. If the clinically delivered treatment plan did not comply with defined target coverage requirements, the plan was modified retrospectively until sufficient coverage was reached. The choice of selection criteria was based on the estimated number of eligible patients for different heart and lung dose thresholds in combination with proton therapy capacity limitations and dose-response relationships for heart and lung.Results: Median mean heart dose was 3.0 Gy (range, 1.1-8.2 Gy) for left-sided and 1.4 Gy (0.4-11.5 Gy) for right-sided treatment plans. Median V17Gy/V20Gy (hypofractionated/normofractionated plans) for ipsilateral lung was 31% (9-57%). The DBCG Radiotherapy Committee chose mean heart dose > 4 Gy and/or lung V17Gy/V20Gy >= 37% as thresholds for inclusion in the randomised trial. Using thesethresholds, we estimate that 22% of patients requiring loco-regional IMN radiotherapy will be eligible for the trial.Conclusion: The patient selection criteria for the DBCG Proton Trial are mean heart dose >= 4 Gy and/or lung V17Gy/V20Gy >= 37%. (C) 2021 The Author(s). Published by Elsevier B.V. on behalf of European Society for Radiotherapy and Oncology.
KW - Patient selection
KW - Breast cancer
KW - Proton therapy
KW - Heart and lung exposure
U2 - 10.1016/j.ctro.2021.01.012
DO - 10.1016/j.ctro.2021.01.012
M3 - Journal article
C2 - 33659716
VL - 27
SP - 126
EP - 131
JO - Clinical and Translational Radiation Oncology
JF - Clinical and Translational Radiation Oncology
SN - 2405-6308
ER -
ID: 260254788