Preliminary clinical results of accelerated IMRT with concomitant boost after breast conserving therapy (BCT)
Bibliographic record
Abstract
860 Background: Inspired by the Canadian prospective randomized trial that demonstrated comparable 5-year safety and efficacy of accelerated (16 fractions) whole breast RT versus standard RT (25 fractions), we have started a protocol of accelerated intensity-modulated radiation therapy (AIMRT) after BCT. Methods: A protocol of 15 fractions over 3 weeks is offered to Stage I-II patients who have undergone BCT. Patients are treated in the prone position, to reduce breathing motion and to enable treatment of the index breast while sparing the other breast, the lung and heart tissue. Dynamic intensity modulated multiple photon fields are used to deliver 15 daily fractions of 2.7 Gy (40.5 Gy total dose) to the index breast with a simultaneous in-field boost of 0.5 Gy (48 Gy total dose) to the tumor bed(PTV). At prone CT planning, the index breast is defined and is encompassed by beams placed tangentially to the anterior edge of the chest wall. The superior and inferior margins are clinically determined at the time of simulation. Similarly, the PTV is defined as the post-surgical cavity, plus a 1.0 cm margin. Results: Since September 2003, eleven patients with Stage I(n=7) and IIA(n=4) breast cancer entered the study and were treated with either 3 or 4 non-coplanar IMRT fields. DVH Analysis: The median % volume of breast tissue outside the PTV(Br-PTV) receiving 110% and 125% of the prescription dose(PD 40.5 Gy) was 37.6% (SD±10.87) and 4.04% (SD±3.77), respectively. The median % dose covering 95% of the PTV volume(D95) was 118.6 % of the PD (SD±1.93). Five % of the ipsilateral lung received 7.2%(SD±8.4) of the PD(291.6 cGy), while five % of the heart received 7.3%(SD±2.7) of the PD(295.7 cGy). Conclusions: Preliminary data suggest that it is technically feasible to plan and treat by AIMRT the ipsilateral breast with a concomitant boost. Prone positioning reduces breathing movement and spares heart and lung tissue. No significant financial relationships to disclose.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".