Designing clinical trials based on modern imaging and metastasis-directed treatments in patients with oligometastatic breast cancer: a consensus recommendation from the EORTC Imaging and Breast Cancer Groups.

Breast cancer remains the most common cause of cancer death among women. Despite its considerable histological and molecular heterogeneity, those characteristics are not distinguished in most definitions of oligometastatic disease and clinical trials of oligometastatic breast cancer. After an exhaustive review of the literature covering all aspects of oligometastatic breast cancer, 35 experts from the European Organisation for Research and Treatment of Cancer Imaging and Breast Cancer Groups elaborated a Delphi questionnaire aimed at offering consensus recommendations, including oligometastatic breast cancer definition, optimal diagnostic pathways, and clinical trials required to evaluate the effect of diagnostic imaging strategies and metastasis-directed therapies.

Completeness of Reporting Oligometastatic Disease Characteristics in the Literature and Influence on Oligometastatic Disease Classification Using the ESTRO/EORTC Nomenclature.

Purpose: There is increasing evidence for the integration of locally ablative therapy into multimodality treatment of oligometastatic disease (OMD). To support standardised data collection, analysis, and comparison, a consensus OMD classification based on fundamental disease and treatment characteristics has previously been established. This study investigated the completeness of reporting the proposed OMD characteristics in literature and evaluated whether the proposed OMD classification system can be applied to the historical data.

Validation of a prognostic scoring system for postmastectomy locoregional recurrence in breast cancer.

Background: To date, it remains unclear which patients with breast cancer (BC) benefit from post-mastectomy radiotherapy (PMRT). Cheng et al. developed and validated a scoring system based on 4 prognostic factors for locoregional recurrence (LRR) to identify patients in need for PMRT.

Defining oligometastatic disease from a radiation oncology perspective: An ESTRO-ASTRO consensus document.

Background: Recognizing the rapidly increasing interest and evidence in using metastasis-directed radiotherapy (MDRT) for oligometastatic disease (OMD), ESTRO and ASTRO convened a committee to establish consensus regarding definitions of OMD and define gaps in current evidence.

Methods: A systematic literature review focused on curative intent MDRT was performed in Medline, Embase and Cochrane. Subsequent consensus opinion, using a Delphi process, highlighted the current state of evidence and the limitations in the available literature.

The financial impact of SBRT for oligometastatic disease: A population-level analysis in Belgium.

Introduction: There is a steady rise in Stereotactic Body RadioTherapy (SBRT) utilization in oligometastatic disease (OMD). This may generate important financial consequences for radiotherapy budgets. The National Institute for Health and Disability Insurance of Belgium (NIHDI) initiated a coverage with evidence development (CED) project for innovative radiotherapy, including SBRT, in 2011.

Validation of a normal tissue complication probability model for late unfavourable aesthetic outcome after breast-conserving therapy.

Purpose: To validate a normal tissue complication probability (NTCP) model for late unfavourable aesthetic outcome (AO) after breast-conserving therapy.

Materials/methods: The BCCT.core software evaluated the AO using standardized photographs of patients treated at the University Hospitals Leuven between April 2015 and April 2016.

A comparison of a brachytherapy and an external beam radiotherapy boost in breast-conserving therapy for breast cancer: local and any recurrences.

Purpose: Adding a tumour bed boost to whole-breast irradiation in breast-conserving therapy reduces local recurrence rates. The purpose of the present study was to investigate whether the boost technique influences the magnitude of the effect.

Methods: Patients treated with breast-conserving therapy for invasive breast cancer between 2000 and 2007 were included in the analysis.

Development of a normal tissue complication probability model for late unfavourable aesthetic outcome after breast-conserving therapy.

Purpose/objectives: To develop a normal tissue complication probability (NTCP) model for late unfavourable aesthetic outcome (AO) after breast-conserving therapy.

Material And Methods: The BCCT.core software evaluated the AO using standardized photographs of patients treated between 2009 and 2014.

Feasibility study of individualized optimal positioning selection for left-sided whole breast radiotherapy: DIBH or prone.

The deep inspiration breath hold (DIBH) and prone (P) position are two common heart-sparing techniques for external-beam radiation treatment of left-sided breast cancer patients. Clinicians select the position that is deemed to be better for tissue sparing based on their experience. This approach, however, is not always optimum and consistent.

Tumour bed boost radiotherapy for women after breast-conserving surgery.

Background: Breast-conserving therapy, involving breast-conserving surgery followed by whole-breast irradiation and optionally a boost to the tumour bed, is a standard therapeutic option for women with early-stage breast cancer. A boost to the tumour bed means that an extra dose of radiation is applied that covers the initial tumour site. The rationale for a boost of radiotherapy to the tumour bed is that (i) local recurrence occurs mostly at the site of the primary tumour because remaining microscopic tumour cells are most likely situated there; and (ii) radiation can eliminate these causative microscopic tumour cells.

I brachytherapy in younger prostate cancer patients : Outcomes in low- and intermediate-risk disease.

Purpose: To evaluate local recurrence in younger men treated with low-dose-rate (LDR) I brachytherapy (BT) for localized prostate cancer.

Patients And Methods: A total of 192 patients (≤65-years-old) were treated with LDR I-BT ± hormone therapy. Local failure was defined as any prostate-specific antigen (PSA) rise leading to salvage treatment or biochemical failure according to the Phoenix definition.

Boost delineation in breast radiation therapy: Isotropic versus anisotropic margin expansion.

Purpose: The purpose of this article is to compare isotropic and anisotropic margin expansion with regard to the size of the clinical target volume boost (CTV) and the interobserver variability (IOV).

Methods And Materials: Lumpectomy cavities marked with 3 or more surgical clips were delineated by 6 radiation oncologists who specialized in breast radiation therapy. CTV was created by manually expanding the tumor bed with an anisotropic margin of 15 mm (20 mm in case of extensive intraductal component) minus the surgical free margins in 6 directions (anteroposterior, craniocaudal, and superoinferior).

Validation of the Web-Based IBTR! 2.0 Nomogram to Predict for Ipsilateral Breast Tumor Recurrence After Breast-Conserving Therapy.

Purpose: To evaluate the IBTR! 2.0 nomogram, which predicts 10-year ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy with and without radiation therapy for breast cancer, by using a large, external, and independent cancer center database.

Methods And Materials: We retrospectively identified 1898 breast cancer cases, treated with breast-conserving therapy and radiation therapy at the University Hospital Leuven from 2000 to 2007, with requisite data for the nomogram variables.

Is the use of a preoperative computed tomography beneficial to reduce the interobserver variability of the CTV delineation for breast radiation therapy?

Purpose: To determine whether the use of a preoperative (preop) computed tomography (CT) reduces (1) the clinical target volume boost (CTV) and (2) the interobserver variability (IOV) of the delineated CTV in breast radiation therapy.

Methods And Materials: In patients treated with breast-conserving therapy, 3 CT scans in treatment position were performed: (1) preop; (2) after surgery, prechemotherapy (postop); and (3) postchemotherapy (postchemo). Six radiation-oncologists delineated the tumor bed and CTV before and after fusion of the preop CT.

Evaluation of a breast cancer nomogram to predict ipsilateral breast relapse after breast-conserving therapy.

Background And Purpose: A nomogram to predict for the 10-year ipsilateral breast relapse (IBR) after breast-conserving therapy (BCT) for breast cancer (BC) was developed based on the 'boost-no-boost'-trial with a concordance probability estimate (CPE) of 0.68. The aim of our study was to validate that algorithm.

A comparison of three different radiotherapy boost techniques after breast conserving therapy for breast cancer.

Purpose: Compare different boost techniques after breast conserving therapy (BCT) in terms of local and loco-regional recurrences.

Materials And Methods: From 2000 to 2005, patients treated with BCT for invasive breast cancer (BC) were included. An electron boost (EB) was performed for a superficial boost-volume (less than 29 mm under the epidermis), in all other cases a brachytherapy boost (BTB) was proposed.

Case report of cold-weather-induced radiation recall dermatitis after chemoradiotherapy with cisplatin.

Background: The radiation recall reaction (RRR) is an inflammatory reaction that occurs in previously irradiated areas. The phenomenon is probably due to an idiosyncratic hypersensitivity reaction, in which a second agent can recall the inflammatory reaction.

Case Report: This case report documents a cold-weather-induced radiation recall dermatitis (RRD).