Electron Beam Intraoperative Radiotherapy (ELIOT) in Pregnant Women with Breast Cancer: From in Vivo Dosimetry to Clinical Practice

被引:10
作者
Leonardi, Maria [1 ]
Cecconi, Agnese [2 ,3 ]
Luraschi, Rosa [4 ]
Rondi, Elena [4 ]
Cattani, Federica [4 ]
Lazzari, Roberta [1 ]
Morra, Anna [1 ]
Soto, Santos [5 ]
Zanagnolo, Vanna [6 ]
Galimberti, Viviana [7 ]
Gentilini, Oreste [7 ,8 ]
Peccatori, Fedro [9 ]
Jereczek-Fossa, Barbara [1 ,3 ]
Orecchia, Roberto [2 ,3 ,10 ]
机构
[1] European Inst Oncol, Adv Radiotherapy Ctr, Milan, Italy
[2] European Inst Oncol, Sci Direct, Milan, Italy
[3] Univ Milan, Milan, Italy
[4] European Inst Oncol, Unit Med Phys, Milan, Italy
[5] Med Sur Hosp, Breast Ctr, Mexico City, DF, Mexico
[6] European Inst Oncol, Gynecol Canc Surg, Milan, Italy
[7] European Inst Oncol, Breast Canc Surg, Milan, Italy
[8] San Raffaele Univ Hosp, Breast Surg Unit, Milan, Italy
[9] European Inst Oncol, Fertil & Procreat Unit, Milan, Italy
[10] CNAO Fdn, Natl Ctr Oncol Hadrontherapy, Pavia, Italy
关键词
Breast cancer; Pregnancy; Radiation therapy; OF-THE-LITERATURE; RADIATION-EXPOSURE; MONTE-CARLO; IRRADIATION; PATIENT; OUTCOMES; ORGANS;
D O I
10.1159/000479862
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: The aim of this study was to confirm our preliminary results with in vivo dosimetry in non-pregnant breast cancer patients receiving electron beam intraoperative radiotherapy (ELIOT) and to report on the first treatment in a pregnant woman. Patients and Methods: Following our previous experience, 5 non-pregnant patients receiving ELIOT to the tumor bed after breastconserving surgery (BCS) were studied with thermoluminescent dosimeters positioned in the subdiaphragmatic region, within the uterus, and in the ovarian region. In December 2011, the first pregnant breast cancer patient underwent BCS and ELIOT (21 Gy at 90% isodose) during the 15th week of gestation. Results: The mean dose to the subdiaphragmatic external region in the 5 nonpregnant patients was 5.57 mGy, while pelvic measurements were below 1 mGy. The actual dosimetry of the pregnant patient showed a mean subdiaphragmatic dose of 4.34 mGy, a mean suprapubic dose of 1.64 mGy, and mean ovarian doses of 1.48 mGy (right-sided) and 1.44 mGy (left-sided). The expected dose to the fetus was estimated as 0.84 mGy (0.004% of the prescribed dose). Conclusion: ELIOT as an anticipated boost to the breast could be considered in pregnant women in the early second trimester, postponing whole-breast irradiation after delivery. (C) 2017 S. Karger GmbH, Freiburg
引用
收藏
页码:396 / 400
页数:5
相关论文
共 36 条
[1]   Management of cancer in pregnancy [J].
Amant, Frederic ;
Han, Sileny N. ;
Mhallem, Mina ;
Vandenbroucke, Tineke ;
Verheecke, Magali ;
Van Calsteren, Kristel .
BEST PRACTICE & RESEARCH CLINICAL OBSTETRICS & GYNAECOLOGY, 2015, 29 (05) :741-753
[2]   Breast cancer in pregnancy: Recommendations of an international consensus meeting [J].
Amant, Frederic ;
Deckers, Sarah ;
Van Calsteren, Kristel ;
Loibl, Sibylle ;
Halaska, Michael ;
Brepoels, Lieselot ;
Beijnen, Jos ;
Cardoso, Fatima ;
Gentilini, Oreste ;
Lagae, Lieven ;
Mir, Olivier ;
Neven, Patrick ;
Ottevanger, Nelleke ;
Pans, Steven ;
Peccatori, Fedro ;
Rouzier, Roman ;
Senn, Hans-Joerg ;
Struikmans, Henk ;
Christiaens, Marie-Rose ;
Cameron, David ;
Du Bois, Andreas .
EUROPEAN JOURNAL OF CANCER, 2010, 46 (18) :3158-3168
[3]   Fetal dose estimates for electron-beam treatment to the chest wall of a pregnant patient [J].
Antolak, JA ;
Strom, EA .
MEDICAL PHYSICS, 1998, 25 (12) :2388-2391
[4]   Managing pregnant women with cancer: personal considerations and a review of the literature [J].
Azim, H. A., Jr. ;
Gentilini, O. ;
Locatelli, M. ;
Ciriello, E. ;
Scarfone, G. ;
Peccatori, F. A. .
ECANCERMEDICALSCIENCE, 2011, 5
[5]   A feasibility study to calculate unshielded fetal doses to pregnant patients in 6-MV photon treatments using Monte Carlo methods and anatomically realistic phantoms [J].
Bednarz, Bryan ;
Xu, X. George .
MEDICAL PHYSICS, 2008, 35 (07) :3054-3061
[6]   Maternal and fetal outcomes of taxane chemotherapy in breast and ovarian cancer during pregnancy: case series and review of the literature [J].
Cardonick, E. ;
Bhat, A. ;
Gilmandyar, D. ;
Somer, R. .
ANNALS OF ONCOLOGY, 2012, 23 (12) :3016-3023
[7]   The relationship between waiting time for radiotherapy and clinical outcomes: A systematic review of the literature [J].
Chen, Zheng ;
King, Will ;
Pearcey, Robert ;
Kerba, Marc ;
Mackillop, William J. .
RADIOTHERAPY AND ONCOLOGY, 2008, 87 (01) :3-16
[8]   Estimation of the radiation dose delivered to any point outside the target volume per patient treated with external beam radiotherapy [J].
Diallo, I ;
Lamon, A ;
Shamsaldin, A ;
Grimaud, E ;
deVathaire, F ;
Chavaudra, J .
RADIOTHERAPY AND ONCOLOGY, 1996, 38 (03) :269-271
[9]   Is Electron Beam Intraoperative Radiotherapy (ELIOT) Safe in Pregnant Women with Early Breast Cancer? In Vivo Dosimetry to Assess Fetal Dose [J].
Galimberti, Viviana ;
Ciocca, Mario ;
Leonardi, Maria Cristina ;
Zanagnolo, Vanna ;
Paola, Baratella ;
Manuela, Sargenti ;
Sahium, Rafaela Cecilio ;
Lazzari, Roberta ;
Gentilini, Oreste ;
Peccatori, Fedro ;
Veronesi, Umberto ;
Orecchia, Roberto .
ANNALS OF SURGICAL ONCOLOGY, 2009, 16 (01) :100-105
[10]   Safety of sentinel node biopsy in pregnant patients with breast cancer [J].
Gentilini, O ;
Cremonesi, M ;
Trifirò, G ;
Ferrari, M ;
Baio, SM ;
Caracciolo, M ;
Rossi, A ;
Smeets, A ;
Galimberti, V ;
Luini, A ;
Tosi, G ;
Paganelli, G .
ANNALS OF ONCOLOGY, 2004, 15 (09) :1348-1351