Gillian Ross - Royal Marsden Hospital
Gillian Ross - Royal Marsden Hospital
Gillian Ross - Royal Marsden Hospital
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The <strong>Royal</strong> <strong>Marsden</strong><br />
Breast cancer<br />
radiotherapy:<br />
less is more!<br />
Dr <strong>Gillian</strong> <strong>Ross</strong><br />
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The <strong>Royal</strong> <strong>Marsden</strong><br />
Contents<br />
1. New approaches to irradiating only tumour bed<br />
2. Managing brains metastases in 21C!<br />
3. “Oligometastatic disease” role of 3D conformal RT
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The <strong>Royal</strong> <strong>Marsden</strong><br />
Partial breast radiotherapy
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The <strong>Royal</strong> <strong>Marsden</strong><br />
Rationale for tumour bed radiotherapy after<br />
lumpectomy: is it “safe”<br />
– Lumpectomy+RT equivalent to mastectomy<br />
for survival.<br />
– Most “recurrences” in breast are at primary<br />
site
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The <strong>Royal</strong> <strong>Marsden</strong><br />
How can we give “tumour bed”<br />
radiotherapy<br />
– Intraoperative; single treatment<br />
– Postoperative<br />
– “PARTIAL “ breast LINAC ; standard duration<br />
– “PARTIAL” breast; Mammosite catheter = 5 days!
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The <strong>Royal</strong> <strong>Marsden</strong><br />
Partial breast RT trials<br />
– IMPORT-WB vs PB 3D LINAC-based<br />
– FORUM- PhII Mammosite brachytherapy<br />
– TARGET-Ph III WB vs intraoperative PB
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The <strong>Royal</strong> <strong>Marsden</strong><br />
Intra-operative radiotherapy:<br />
Targit trial
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The <strong>Royal</strong> <strong>Marsden</strong>
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The <strong>Royal</strong> <strong>Marsden</strong>
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The <strong>Royal</strong> <strong>Marsden</strong>
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The <strong>Royal</strong> <strong>Marsden</strong><br />
Breast cancer brain metastases<br />
– MRI gives excellent detail of size, location<br />
– Stereotactic “3D” treatment of individual lesions<br />
avoids hair loss, somnolence, cognitive problems<br />
– Mean survival 14 months after effective RT
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The <strong>Royal</strong> <strong>Marsden</strong><br />
What is “Oligometastatic” disease<br />
A future target for modern 3D equipment!<br />
– Typically small numbers of vertebral bony lesions<br />
– Small volume lung deposits<br />
– Potential candidates for 3D highly localised RT in 1-3<br />
doses
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The <strong>Royal</strong> <strong>Marsden</strong><br />
Contact details<br />
<strong>Gillian</strong> <strong>Ross</strong><br />
Email<br />
<strong>Gillian</strong>.ross@rmh.nhs.uk<br />
<strong>Royal</strong> <strong>Marsden</strong> NHS Trust<br />
Fulham Road<br />
SW3 6JJ<br />
Address 04<br />
Tel 0207 808 2721
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