naa a22 4500 510763103 CHVBK 20180411083146.0 cr unu---uuuuu 180411e20130101xx s 000 0 eng 10.1007/s12094-012-0884-1 doi (NATIONALLICENCE)springer-10.1007/s12094-012-0884-1 Tumor bed segmentation: first step for partial breast irradiation [Elektronische Daten] [Amparo González Sanchis, Luis Brualla González, Carlos Fuster Diana, Jose Gordo Partearroyo, Andres Garcia-Vilanova Comas, Jose Lopez Torrecilla, Joan Roselló Ferrando] Introduction: In breast IMRT simultaneous integrated boost (SIB) treatment and accelerated partial breast irradiation (APBI), proper delineation of the tumor bed is necessary. Conservative oncoplastic surgery causes changes in peritumoral breast tissue that complicates locating the site of the tumor. Nevertheless, there are still centers that do not use surgical clips to delineate the site. This study aims to show how the lack of clips affects the techniques of SIB and APBI in terms of dose distribution and safety margins in the tumor bed. Materials and methods: On 30 patients, the defining of the tumor bed obtained from the pre-surgery CT scan to that outlined on the basis of clips on the post-surgery CT was compared. Tumor bed deviation from the original tumor site was quantified. In addition, the margins to the original tumor site necessary to guarantee the coverage of the tumor bed were calculated. Results: Variations were detected in the distances between geometric centers of the PTV (minimum 0.5-maximum 3cm). The maximum margin necessary to include the entire tumor bed was 4.5cm. Lesions located in the upper outer quadrant required the widest margins. If margins are not added, the tumor bed volume defined with clips will be underdosed. Conclusions: The definition of the tumor bed based on studies before surgery does not have the necessary accuracy. Clips need to be placed in the surgical bed to identify the changes occurring after the restorative mammoplasty. Without clips, SIB and APBI are not safe. Federación de Sociedades Españolas de Oncología (FESEO), 2012 Breast IMRT nationallicence APBI nationallicence Surgical clips nationallicence Tumor bed nationallicence Hypofraction nationallicence González Sanchis Amparo Radiation Oncology Department, ERESA, Hospital General Universitario de Valencia (CHGUV), Avenida Tres Cruces, no 2, 46014, Valencia, Spain aut Brualla González Luis Radiophysics Department, ERESA, Hospital General Universitario de Valencia (CHGUV), Valencia, Spain aut Fuster Diana Carlos Breast Surgery Department, Hospital General Universitario de Valencia (CHGUV), Valencia, Spain aut Gordo Partearroyo Jose Radiation Oncology Department, ERESA, Hospital General Universitario de Valencia (CHGUV), Avenida Tres Cruces, no 2, 46014, Valencia, Spain aut Garcia-Vilanova Comas Andres Breast Surgery Department, Hospital General Universitario de Valencia (CHGUV), Valencia, Spain aut Lopez Torrecilla Jose Radiation Oncology Department, ERESA, Hospital General Universitario de Valencia (CHGUV), Avenida Tres Cruces, no 2, 46014, Valencia, Spain aut Roselló Ferrando Joan Radiophysics Department, ERESA, Hospital General Universitario de Valencia (CHGUV), Valencia, Spain aut Clinical and Translational Oncology Springer Milan 15/1(2013-01-01), 39-45 1699-048X 15:1<39 2013 15 12094 https://doi.org/10.1007/s12094-012-0884-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12094-012-0884-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- González Sanchis Amparo Radiation Oncology Department, ERESA, Hospital General Universitario de Valencia (CHGUV), Avenida Tres Cruces, no 2, 46014, Valencia, Spain aut NATIONALLICENCE 700 1- Brualla González Luis Radiophysics Department, ERESA, Hospital General Universitario de Valencia (CHGUV), Valencia, Spain aut NATIONALLICENCE 700 1- Fuster Diana Carlos Breast Surgery Department, Hospital General Universitario de Valencia (CHGUV), Valencia, Spain aut NATIONALLICENCE 700 1- Gordo Partearroyo Jose Radiation Oncology Department, ERESA, Hospital General Universitario de Valencia (CHGUV), Avenida Tres Cruces, no 2, 46014, Valencia, Spain aut NATIONALLICENCE 700 1- Garcia-Vilanova Comas Andres Breast Surgery Department, Hospital General Universitario de Valencia (CHGUV), Valencia, Spain aut NATIONALLICENCE 700 1- Lopez Torrecilla Jose Radiation Oncology Department, ERESA, Hospital General Universitario de Valencia (CHGUV), Avenida Tres Cruces, no 2, 46014, Valencia, Spain aut NATIONALLICENCE 700 1- Roselló Ferrando Joan Radiophysics Department, ERESA, Hospital General Universitario de Valencia (CHGUV), Valencia, Spain aut NATIONALLICENCE 773 0- Clinical and Translational Oncology Springer Milan 15/1(2013-01-01), 39-45 1699-048X 15:1<39 2013 15 12094 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer