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Displacement of Surgical Clips in Patients with Human Acellular Dermal Matrix in the Excision Cavity during Whole Breast Irradiation Following Breast-Conserving Surgery

Title
Displacement of Surgical Clips in Patients with Human Acellular Dermal Matrix in the Excision Cavity during Whole Breast Irradiation Following Breast-Conserving Surgery
Authors
Jung, WonguenKim, KyuboPaik, Nam Sun
Ewha Authors
백남선김규보
SCOPUS Author ID
백남선scopus; 김규보scopus
Issue Date
2020
Journal Title
CANCER RESEARCH AND TREATMENT
ISSN
1598-2998JCR Link

2005-9256JCR Link
Citation
CANCER RESEARCH AND TREATMENT vol. 52, no. 2, pp. 388 - 395
Keywords
Breast-conserving surgerySurgical clipDisplacementRadiotherapyAcellular dermal matrix
Publisher
KOREAN CANCER ASSOCIATION
Indexed
SCIE; SCOPUS; KCI WOS scopus
Document Type
Article
Abstract
Purpose The purpose of this study was to investigate the displacement of surgical clips in the excision cavity during whole breast irradiation following breast-conserving surgery (BCS) with or without acellular dermal matrix (ADM) insertion, and to analyze clinicopathologic factors associated with the displacement of surgical clips. Materials and Methods From 2016 to 2017, 100 consecutive breast cancer patients who underwent BCS with the placement of surgical clips (superior, inferior, medial, lateral, and deep sides) in the tumor bed were included in this study. All patients took first planning computed tomography (CT) scan (CT 1) before whole breast irradiation and second CT scan (CT 2) before boost irradiation. Between two sets of planning CT, the displacement of surgical clips was calculated from the Delta X (lateral-medial), Delta Y (anterior-posterior), Delta Z (superior-inferior), and three-dimensional (3D) directions. Patients were divided into two groups according to the breast volume replacement with ADM: group A with ADM and group B without ADM. Results The means and 1 standard deviations of 3D displacement for superior, inferior, medial, lateral and deep clips were 5.2 +/- 2.9, 5.2 +/- 3.2, 5.6 +/- 4.5, 5.6 +/- 43, and 4.9 +/- 4.9 mm in entire cohort (n=100); 5.6 +/- 2.6, 6.0 +/- 3.5, 6.7 +/- 5.8, 6.7 +/- 5.7, and 6.1 +/- 7.4 mm in group A (n=38); 4.9 +/- 3.1, 4.8 +/- 3.0, 5.0 +/- 3.5, 5.0 +/- 2.9, and 4.3 +/- 2.8 mm in group B (n=62), respectively. The 3D displacements of group A were longer than those of group B, but only significant difference was observed in lateral clip (p=0.047). Conclusion This study demonstrated displacement of surgical clips during whole breast irradiation in patients with ADM insertion. For patients who had breast volume replacement using ADM, adaptive boost planning should be considered.
DOI
10.4143/crt.2019.213
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의과대학 > 의학과 > Journal papers
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