Cardiotoxicity of breast cancer radiotherapy – overview of current results

Adjuvant radiotherapy after breast cancer surgery is an important part of breast cancer treatment improving local control and overall survival. However, a higher risk of cardiac mortality was observed when conventional radiotherapy techniques were used. Cardiac morbidity and mortality after radiation therapy have been studied in many meta-analyses. In those focused on modern radiotherapy techniques, cardiac morbidity and mortality were no longer presented. However, an extremely long follow-up period is required. Importantly, the cardiac morbidity rates vary depending not only on the dose delivered to the heart, but also on the systemic therapies administrated and the pre-existing cardiac disease. Systematic heart dose monitoring is of great importance, as are efforts to constantly decrease doses, using advanced radiotherapy techniques. Nowadays, it is essential to individualize treatment according to tumor characteristics and anatomical predispositions, and to consider the cost and benefits

Largest Phyllodes Tumor- Case Report and Brief Review Article

This is an article reporting the largest phyllodes tumor and the role of radiotherapy in patients of phyllodes tumor of breast, based on Medline search for articles in English language using keywords “role of radiotherapy in phyllodes tumor of breast”. 32 years female presented with a lump in right breast since last 4 months. This was the second recurrence of similar lump in last 6 years. Biopsy from the lump proved to be cystosarcoma phyllodes. Radical Mastectomy with level I node sampling and reconstruction with Latissimus Dorsi Myocutaneous flap was done as a curative procedure. The tumor measured exactly to be 50 × 25.2 × 16.4 cm in size and 15 kg in weight. Proliferation markers like Ki- 67 and p53 were in the range of 1-2% and 3-4% respectively. Histopathological diagnosis of the tumor was borderline phyllodes tumor. Patient had an uneventful postoperative course and is presently on three monthly follow up since 1 year

Updated results of high-dose rate brachytherapy and external beam radiotherapy for locally and locally advanced prostate cancer using the RTOG-ASTRO phoenix definition

PURPOSE: To evaluate the prognostic factors for patients with local or locally advanced prostate cancer treated with external beam radiotherapy (RT) and high dose rate brachytherapy (HDR) according to the RTOG-ASTRO Phoenix Consensus Conference. MATERIALS AND METHODS: The charts of 209 patients treated between 1997 and 2005 with localized RT and HDR as a boost at the Department of Radiation Oncology, AC Camargo Hospital, Sao Paulo, Brazil were reviewed. Clinical and treatment parameters i.e.: patient's age, Gleason score, clinical stage, initial PSA (iPSA), risk group (RG) for biochemical failure, doses of RT and HDR were evaluated. Median age and median follow-up time were 68 and 5.3 years, respectively. Median RT and HDR doses were 45 Gy and 20 Gy. RESULTS: Disease specific survival (DSS) at 3.3 year was 94.2%. Regarding RG, for the LR (low risk), IR (intermediate risk) and HR (high risk), the DSS rates at 3.3 years were 91.5%, 90.2% and 88.5%, respectively. On univariate analysis prognostic factors related to DSS were RG (p = 0.040), Gleason score &#8804; 6 ng/mL (p = 0.002), total dose of HDR &#8805; 20 Gy (p < 0.001) On multivariate analysis the only statistical significant predictive factor for biochemical control (bNED) was the RG, p < 0.001 (CI - 1.147-3.561). CONCLUSIONS: Although the radiation dose administered to the prostate is an important factor related to bNED, this could not be established with statistical significance in this group of patients. To date , in our own experience, HDR associated to RT could be considered a successful approach in the treatment of prostate cancer