Reproducibility of Deep-Inspiration Breath Hold treatments on Halcyon™ performed using the first clinical version of AlignRT InBore™: Results of CYBORE study.

Background and purpose: To investigate the reproducibility of deep-inspiration breath hold (DIBH) breast cancer treatments on Halcyon™ performed using the first clinical version of AlignRT InBore™ (Vision RT Ltd., London, UK), a Halcyon's SGRT dedicated solution. Materials and methods: The ease and feasibility of DIBH treatments was retrospectively investigated for the initial 22 left breast cancer patients treated on Halcyon™ using AlignRT InBore™. Setup time, Cone beam computed tomography (CBCT) imaging and analysis time as well as overall treatment time were recorded. Online and offline review of CBCT images was undertaken to verify the compliance of breast, heart, spine, sternum and diaphragmatic domes positions. Results: Mean duration of patient setup, CBCT analysis and overall treatment time were 4 min, 1.1 min and 14 min respectively. Online review of 520 CBCT acquisitions by therapists showed minimal positioning shifts with AlignRT InBore™ guidance with mean value of vertical, longitudinal, and lateral shifts of 1.7 mm, -1.7 mm, and -0.2 mm respectively. Meanwhile, offline review of 115 CBCTs by the radiation oncologist, showed reproducible breath hold (BH) with average deviation of breast, heart, spine, sternum and diaphragmatic domes respectively within 2.4 mm, 2.9 mm, 3.3 mm, 3.2 mm and 4.5 mm in magnitude. Conclusion: AlignRT InBore™ allows for accurate and reproducible DIBH on Halcyon™ with breast and heart organs' positions within 3 mm in magnitude of expected position and fully compliant with planning margins (5 mm anisotropic CTV-PTV margins).

[Radiotherapy for ovarian carcinoma management: Literature review]. / Place de la radiothérapie dans le traitement des cancers ovariens : revue de la littérature.

Ovarian cancer is the fifth most common cancer in women in France with 4714 new cases in 2017. More than 70% of patients whose disease is initially locally advanced will present locoregional or distant recurrence. Therapeutic options in this situation are not consensual. They are based on chemotherapy possibly associated with an iterative cytoreductive surgery when it is bearable by the patient. The place of radiotherapy in the management of the disease is hidden in the vast majority of national or international standards. We conducted a general review of the literature to clarify the role of irradiation in the global management of ovarian cancers, particularly in recurrence.

[Safety and efficacy of whole breast irradiation with a concomitant boost: analysis of 121 cases treated at the Institute of Cancerology of Lorraine]. / Efficacité et sécurité de la technique de radiothérapie mammaire avec complément d'irradiation concomitant : analyse de 121 cas traités à l'institut de cancérologie de Lorraine.

PURPOSE: To evaluate the safety and efficacy of whole breast irradiation with a concomitant boost. PATIENTS AND MATERIALS: This is a retrospective study of 121 patients with node negative T1-T2 breast tumors inferior to 3 cm in diameter, previously treated by conservative surgery without chemotherapy. A dose of 50 Gy was delivered to the whole breast in 2 Gy daily fractions with 5 weekly treatments. A concomitant boost to the lumpectomy site delivered a total of 10 Gy in 1 Gy fractions twice a week. This would result in an equivalent tumour bed dose (assuming an α/ß of 4) of approximately 65 Gy in 2 Gy fractions. RESULTS: Over 7 years, 121 patients were treated. The median age was 67 years (range, 46-86 years). Stage distribution was: 115 T1, 6 T2; 116 tumors had positive hormonal receptors, 6 grade SBR3. With a median follow-up of 6 years (range, 1.4-11.4 years), 5-year overall survival was 98.2% (95% confidence interval [CI] 0.95-1), disease-free survival was 100% and local recurrence-free survival 100%. The maximum acute skin toxicity by the end of treatment was grade 2. Cosmetic outcomes were good on the long term. One spontaneous rib fracture was observed 1 year after radiotherapy among 76 patients. CONCLUSIONS: The study shows that whole breast radiation therapy with a concomitant boost is safe and effective for selected patients with low risk of relapse, and gives excellent long term results. This protocol represents a good alternative to longer standard whole breast radiation therapy with sequential boost to the lumpectomy bed.