Astro-Physics mounts at Concordia Station. Summer maintenance.
Astro-Physics mounts at Concordia Station, Dome C, Antarctica. I forgot the keypad outside for two days, which withstood -55C without problem. The blinking effect of the screen is an optical...

By: Gilles Cohen

Originally posted here:

Astro-Physics mounts at Concordia Station. Summer maintenance. - Video

PUBLIC RELEASE DATE:

29-Jan-2014

Contact: Brittany Ashcroft press@astro.org 703-839-7336 American Society for Radiation Oncology

Fairfax, Va., January 29, 2014 Standard external beam radiation therapy (EBRT) provided a higher breast preservation rate than brachytherapy in women age 66 and older with invasive breast cancer, according to a study published in the February 1, 2014 print edition of the International Journal of Radiation Oncology Biology Physics (Red Journal), the official scientific journal of the American Society for Radiation Oncology (ASTRO).

Brachytherapy after lumpectomy is an increasingly popular treatment protocol for breast cancer; however, there is conflicting data regarding its effectiveness. Additionally, published suitability criteria directing patient selection for brachytherapy have not been empirically validated. This study compares the long-term likelihood of breast preservation, risks of post-operative complications and local toxicities, and validity of suitability categories of three treatment strategies after lumpectomy: EBRT, brachytherapy and no radiation.

This study used the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database to identify 35,947 women, age 66 and older, diagnosed with invasive breast cancer (79.9 percent) or ductal carcinoma in situ (DCIS) (20.1 percent) from 2002 to 2007 and treated with lumpectomy alone (23 percent), lumpectomy followed by brachytherapy (3.6 percent) or lumpectomy followed by EBRT (73.4 percent). Patients with invasive breast cancer were also classified as suitable (34.7 percent), cautionary (17.6 percent) or unsuitable (35.2 percent) for brachytherapy based on ASTRO's Accelerated Partial Breast Irradiation Consensus Statement. Twelve-and-a-half percent of patients were unclassified. The patients with DCIS in this study were analyzed separately. For this study, patients age 70 or older were classified as "older suitable."

The median follow-up for patients was 3.5 years. For this study, subsequent mastectomy is defined as a claim for mastectomy identified from one year after diagnosis until December 31, 2009, which was the last date of follow-up. The five-year cumulative incidence of subsequent mastectomy for patients with invasive breast cancer was 4.7 percent for those treated with lumpectomy alone, 2.8 percent for those treated with lumpectomy followed by brachytherapy and 1.3 percent for those treated with lumpectomy followed by EBRT. In patients with DCIS, 2.2 percent underwent subsequent mastectomy during follow-up. The five-year cumulative incidence of subsequent mastectomy in patients with DCIS was 3.2 percent for those treated with lumpectomy alone, 4.6 percent for those treated with brachytherapy and 1.6 percent for those treated with EBRT.

In this study, brachytherapy was associated with a greater likelihood of breast preservation than lumpectomy alone, while EBRT showed more likelihood of breast preservation than brachytherapy. When stratified into the ASTRO-defined suitability groups, the study found suitable group patients were the least likely to undergo subsequent mastectomy and had the smallest absolute difference when comparing those treated with brachytherapy and those treated with EBRT. The small number of patients with DCIS treated with brachytherapy in this cohort does not allow definitive conclusions on the effectiveness of brachytherapy for these patients.

"Brachytherapy offered a breast preservation benefit, although in general this benefit was slightly less than the benefit derived from standard external beam radiation therapy," said Benjamin D. Smith, MD, a co-author of the study and associate professor in the Department of Radiation Oncology at The University of Texas MD Anderson Cancer Center. "Our findings suggest that certain patients with very favorable tumors do just as well with either brachytherapy or standard external beam radiation therapy, whereas other patients with higher risk tumors seem to do better with standard external beam radiation therapy."

The February 1 print edition of the Red Journal also contains two editorials addressing breast brachytherapy and examining the data from this study. Peter Y. Chen, MD, a radiation oncologist at William Beaumont Health System in Royal Oak, Mich., emphasizes the need to ensure guidelines keep up with changing data. Robert R. Kuske, MD, a radiation oncologist at Arizona Breast Cancer Specialists in Scottsdale, Ariz., and S. Stanley Young, PhD, the assistant director for bioinformatics at the National Institute of Statistical Sciences, explore the reported differences between breast brachytherapy and whole breast irradiation from the statistical and clinical implications.

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EBRT reduces risk of subsequent mastectomy in patients with invasive breast cancer

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Newswise Fairfax, Va., January 29, 2014 Long-term (five-year) outcomes of breast cancer patients receiving adjuvant accelerated partial breast irradiation (APBI) after breast-conserving surgery show excellent tumor control and breast cosmesis (cosmetic outcomes) with minimal late toxicity, according to a study published in the February 1, 2014 print edition of the International Journal of Radiation Oncology Biology Physics (Red Journal), the official scientific journal of the American Society for Radiation Oncology (ASTRO).

APBI delivers highly conformal radiation therapy, during a period of one to two weeks, to the site where the cancer was removed. APBI has seen a 10-fold increase in use from 2002 to 2007 and is currently the focus of several ongoing phase III trials.

The University of Pittsburgh Cancer Institute study examines the long-term outcomes, tumor control and breast cosmesis of a cohort of early-stage and ductal carcinoma in situ (DCIS) breast cancer patients who received a five-day treatment of APBI at the University of Pittsburgh from 2002 to 2007.

The study is a retrospective review of 157 patients with localized breast cancer treated with adjuvant MammoSite, single-lumen balloon-based brachytherapy after breast-conserving surgery from June 1, 2002 to December 31, 2007. For all patients, at least five years had passed since receiving brachytherapy. Patients were all age 40 or older, with 88.5 percent over age 50, and had stage T1-T2 breast cancer, with 82.4 percent in stage T1A-C, 12.2 percent with DCIS, 4.7 percent in stage T2 and 0.7 percent in stage T1mic. Patients were also categorized by demographics and tumor characteristics into suitable, cautionary and unsuitable groups based on recommendations from ASTROs APBI Consensus Statement.

APBI was delivered to a median dose of 34 Gy in 10 fractions over a five-day period. In addition, 89 percent of patients received additional adjuvant systemic therapy, with 66.9 percent receiving hormonal therapy, 13.4 percent chemotherapy and 8.3 percent chemotherapy with hormonal therapy. Follow-up was conducted every three to four months for the first two years post-treatment, and every six months thereafter at the discretion of the patients breast surgeon and radiation oncologist. Baseline mammograms were performed three to six months after treatment, and annually thereafter. In addition, cosmetic outcomes were documented via photography at each visit, and toxicity was assessed during the final follow-up visit.

At a median follow-up of 5.5 years post-treatment, the five-year and seven-year actuarial ipsilateral breast control were 98 percent/98 percent, the lymph nodal control were 99 percent/98 percent and the distant control were 99 percent/99 percent. The breast cancer specific survival was 100 percent at five years and 99 percent at seven years. The overall survival was 89 percent at five years and 86 percent at seven years. There were no significant differences in tumor recurrence or survival rates in the appropriateness subgroups based on ASTROs consensus statement. Good to excellent breast cosmesis was reported in 93.4 percent of patients. Overall toxicity rates were low, and the most common toxicity was telangiectasia, small, dilated blood vessels near the surface of the skin, which was reported in 27 percent of study participants. The study correlated telangiectasia development and the maximum radiation dose to the skin. The study institution practice is to keep maximum skin dose 100 percent and at maximum 125 percent to limit the risk of telangiectasia.

These results may encourage women to choose this convenient five-day treatment and also help radiation oncologists use techniques that can reduce skin dose further, thus further reducing the long-term effects of partial breast radiation therapy on skin changes and breast cosmesis, said Sushil Beriwal, MD, a co-author of the study and a radiation oncologist at the University of Pittsburgh Cancer Center. The promising outcomes seen across subgroups, as defined by prior consensus definitions for appropriate patient selection, suggest that the current metrics for selecting patients for APBI may need to be redefined such that more women may be candidates for less radiation over a shorter time via APBI.

The February 1 print edition of the Red Journal also contains two editorials addressing breast brachytherapy and examining the data from this study. Peter Y. Chen, MD, a radiation oncologist at William Beaumont Health System in Royal Oak, Mich., emphasizes the need to ensure guidelines keep up with changing data. Robert R. Kuske, MD, a radiation oncologist at Arizona Breast Cancer Specialists in Scottsdale, Ariz., and S. Stanley Young, PhD, the assistant director for bioinformatics at the National Institute of Statistical Sciences, explore the reported differences between breast brachytherapy and whole breast irradiation from the statistical and clinical implications.

Continued here:

Extended Outcomes of Adjuvant Accelerated Partial Breast Irradiation Patients Show Excellent Tumor Control, Breast ...

Contact Information

Available for logged-in reporters only

Newswise Fairfax, Va., January 29, 2014 Standard external beam radiation therapy (EBRT) provided a higher breast preservation rate than brachytherapy in women age 66 and older with invasive breast cancer, according to a study published in the February 1, 2014 print edition of the International Journal of Radiation Oncology Biology Physics (Red Journal), the official scientific journal of the American Society for Radiation Oncology (ASTRO).

Brachytherapy after lumpectomy is an increasingly popular treatment protocol for breast cancer; however, there is conflicting data regarding its effectiveness. Additionally, published suitability criteria directing patient selection for brachytherapy have not been empirically validated. This study compares the long-term likelihood of breast preservation, risks of post-operative complications and local toxicities, and validity of suitability categories of three treatment strategies after lumpectomy: EBRT, brachytherapy and no radiation.

This study used the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database to identify 35,947 women, age 66 and older, diagnosed with invasive breast cancer (79.9 percent) or ductal carcinoma in situ (DCIS) (20.1 percent) from 2002 to 2007 and treated with lumpectomy alone (23 percent), lumpectomy followed by brachytherapy (3.6 percent) or lumpectomy followed by EBRT (73.4 percent). Patients with invasive breast cancer were also classified as suitable (34.7 percent), cautionary (17.6 percent) or unsuitable (35.2 percent) for brachytherapy based on ASTROs Accelerated Partial Breast Irradiation Consensus Statement. Twelve-and-a-half percent of patients were unclassified. The patients with DCIS in this study were analyzed separately. For this study, patients age 70 or older were classified as older suitable.

The median follow-up for patients was 3.5 years. For this study, subsequent mastectomy is defined as a claim for mastectomy identified from one year after diagnosis until December 31, 2009, which was the last date of follow-up. The five-year cumulative incidence of subsequent mastectomy for patients with invasive breast cancer was 4.7 percent for those treated with lumpectomy alone, 2.8 percent for those treated with lumpectomy followed by brachytherapy and 1.3 percent for those treated with lumpectomy followed by EBRT. In patients with DCIS, 2.2 percent underwent subsequent mastectomy during follow-up. The five-year cumulative incidence of subsequent mastectomy in patients with DCIS was 3.2 percent for those treated with lumpectomy alone, 4.6 percent for those treated with brachytherapy and 1.6 percent for those treated with EBRT.

In this study, brachytherapy was associated with a greater likelihood of breast preservation than lumpectomy alone, while EBRT showed more likelihood of breast preservation than brachytherapy. When stratified into the ASTRO-defined suitability groups, the study found suitable group patients were the least likely to undergo subsequent mastectomy and had the smallest absolute difference when comparing those treated with brachytherapy and those treated with EBRT. The small number of patients with DCIS treated with brachytherapy in this cohort does not allow definitive conclusions on the effectiveness of brachytherapy for these patients.

Brachytherapy offered a breast preservation benefit, although in general this benefit was slightly less than the benefit derived from standard external beam radiation therapy, said Benjamin D. Smith, MD, a co-author of the study and associate professor in the Department of Radiation Oncology at The University of Texas MD Anderson Cancer Center. Our findings suggest that certain patients with very favorable tumors do just as well with either brachytherapy or standard external beam radiation therapy, whereas other patients with higher risk tumors seem to do better with standard external beam radiation therapy.

The February 1 print edition of the Red Journal also contains two editorials addressing breast brachytherapy and examining the data from this study. Peter Y. Chen, MD, a radiation oncologist at William Beaumont Health System in Royal Oak, Mich., emphasizes the need to ensure guidelines keep up with changing data. Robert R. Kuske, MD, a radiation oncologist at Arizona Breast Cancer Specialists in Scottsdale, Ariz., and S. Stanley Young, PhD, the assistant director for bioinformatics at the National Institute of Statistical Sciences, explore the reported differences between breast brachytherapy and whole breast irradiation from the statistical and clinical implications.

For a copy of the manuscript of the study or the editorials, contact Brittany Ashcroft at 703-839-7336, press@astro.org. For more information about the Red Journal, visit http://www.redjournal.org.

See the rest here:

External Beam Radiation Therapy Reduces Risk of Subsequent Mastectomy in Patients with Invasive Breast Cancer

PUBLIC RELEASE DATE:

29-Jan-2014

Contact: Brittany Ashcroft press@astro.org 703-839-7336 American Society for Radiation Oncology

Fairfax, Va., January 29, 2014 Long-term (five-year) outcomes of breast cancer patients receiving adjuvant accelerated partial breast irradiation (APBI) after breast-conserving surgery show excellent tumor control and breast cosmesis (cosmetic outcomes) with minimal late toxicity, according to a study published in the February 1, 2014 print edition of the International Journal of Radiation Oncology Biology Physics (Red Journal), the official scientific journal of the American Society for Radiation Oncology (ASTRO).

APBI delivers highly conformal radiation therapy, during a period of one to two weeks, to the site where the cancer was removed. APBI has seen a 10-fold increase in use from 2002 to 2007 and is currently the focus of several ongoing phase III trials.

The University of Pittsburgh Cancer Institute study examines the long-term outcomes, tumor control and breast cosmesis of a cohort of early-stage and ductal carcinoma in situ (DCIS) breast cancer patients who received a five-day treatment of APBI at the University of Pittsburgh from 2002 to 2007.

The study is a retrospective review of 157 patients with localized breast cancer treated with adjuvant MammoSite, single-lumen balloon-based brachytherapy after breast-conserving surgery from June 1, 2002 to December 31, 2007. For all patients, at least five years had passed since receiving brachytherapy. Patients were all age 40 or older, with 88.5 percent over age 50, and had stage T1-T2 breast cancer, with 82.4 percent in stage T1A-C, 12.2 percent with DCIS, 4.7 percent in stage T2 and 0.7 percent in stage T1mic. Patients were also categorized by demographics and tumor characteristics into suitable, cautionary and unsuitable groups based on recommendations from ASTRO's APBI Consensus Statement.

APBI was delivered to a median dose of 34 Gy in 10 fractions over a five-day period. In addition, 89 percent of patients received additional adjuvant systemic therapy, with 66.9 percent receiving hormonal therapy, 13.4 percent chemotherapy and 8.3 percent chemotherapy with hormonal therapy. Follow-up was conducted every three to four months for the first two years post-treatment, and every six months thereafter at the discretion of the patient's breast surgeon and radiation oncologist. Baseline mammograms were performed three to six months after treatment, and annually thereafter. In addition, cosmetic outcomes were documented via photography at each visit, and toxicity was assessed during the final follow-up visit.

At a median follow-up of 5.5 years post-treatment, the five-year and seven-year actuarial ipsilateral breast control were 98 percent/98 percent, the lymph nodal control were 99 percent/98 percent and the distant control were 99 percent/99 percent. The breast cancer specific survival was 100 percent at five years and 99 percent at seven years. The overall survival was 89 percent at five years and 86 percent at seven years. There were no significant differences in tumor recurrence or survival rates in the appropriateness subgroups based on ASTRO's consensus statement. Good to excellent breast cosmesis was reported in 93.4 percent of patients. Overall toxicity rates were low, and the most common toxicity was telangiectasia, small, dilated blood vessels near the surface of the skin, which was reported in 27 percent of study participants. The study correlated telangiectasia development and the maximum radiation dose to the skin. The study institution practice is to keep maximum skin dose 100 percent and at maximum 125 percent to limit the risk of telangiectasia.

"These results may encourage women to choose this convenient five-day treatment and also help radiation oncologists use techniques that can reduce skin dose further, thus further reducing the long-term effects of partial breast radiation therapy on skin changes and breast cosmesis," said Sushil Beriwal, MD, a co-author of the study and a radiation oncologist at the University of Pittsburgh Cancer Center. "The promising outcomes seen across subgroups, as defined by prior consensus definitions for appropriate patient selection, suggest that the current metrics for selecting patients for APBI may need to be redefined such that more women may be candidates for less radiation over a shorter time via APBI."

Originally posted here:

Extended outcomes from APBI show tumor control, breast cosmesis and minimal late toxicity