Need Research Data on IMRT!!

I need your help!

I am preparing a case to present to my health plan to allow me to seek IMRT radiation treatment from a provider outside my HMO since (1) my HMO is losing all its radiation oncologists by the end of this summer, and (2) they have no experiences with using IMRT for breast radiation.

I am particularly interested in this treatment method because it is more precise and will lessen the risks to my heart. This is important to me because (1) my mastectomy was on the left side, (2) I am slender, so I have very little tissue between my heart and my outside skin, (3) and I have had Herceptin, which has already placed my heart at some risk.

I have already collected several articles and websites that support my case, but I want more. If any of you have articles or chart notes that you'd be willing to share, I'd love to get copies. And if you know about a cancer center that's doing cutting-edge work in this area, please let me know that too.

I convinced my HMO to approve an initial consult, but of course I need to take it to the next step and get my treatments approved as well.

thanks!!!!!!
Val

Val,
Is this the type of info that you are looking for?

IMRT


Regards
Joe

Thank you for your quick response, Joe :-) I am searching for info beyond the basic, since IMRT hasn't been used for breast radiation much in the past. I have run across quite a bit in the 2 hours since I started my research....below are a few. I plan to ask my oncologist for copies of the articles i found, since you need an online subscription to view them.

The rad onc I saw today published a few papers about it as well.

But, please...if anyone has experienced this type of treatment or has more info, I'd also like to hear from you.

Val



Journal of Clinical Oncology
======================
The Use of Radiotherapy After Mastectomy: A Review of the Literature
Pierce J Clin Oncol.2005; 23: 1706-1717.


International Journal of Radiation Oncology*Biology*Physics
===============================================
Intensity modulation for breast treatment using static multi-leaf collimators, v 46, pages 187-194
Yuan-Chyuan Lo, Gopika Yasuda, Thomas J. Fitzgerald and Marcia M. Urie

Intensity modulation to improve dose uniformity with tangential breast radiotherapy: Initial clinical experience, v48, Pages 1559-1568
Larry L. Kestin, Michael B. Sharpe, Robert C. Frazier, Frank A. Vicini, Di Yan, Richard C. Matter, Alvaro A. Martinez and John W. Wong

A comparison of different intensity modulation treatment techniques for tangential breast irradiation, v45, Pages 1305-1314
Sha X. Chang, Katharin M. Deschesne, Timothy J. Cullip, Stephanie A. Parker and Jon Earnhart


Radiotherapy and Oncology
======================
The delivery of intensity modulated radiotherapy to the breast using multiple static fields , v57, Pages 79-89
Philip M. Evans, Ellen M. Donovan, Mike Partridge, Peter J. Childs, David J. Convery, Sally Eagle, Vibeke N. Hansen, Bridget L. Suter and John R. Yarnold

An improved breast irradiation technique using three-dimensional geometrical information and intensity modulation, v 58, Pages 341-347
Bram van Asselen, Cornelis P. J. Raaijmakers, Pieter Hofman and Jan J. W. Lagendijk

Cardiac avoidance in breast radiotherapy: a comparison of simple shielding techniques with intensity-modulated radiotherapy, v60, Pages 247-255
David Landau, Elizabeth J. Adams, Steve Webb and Gillian Ross

I completed IMRT in November, 2002 at a brand-new facility in California.

AlaskaAngel

hi Angel--
I am encouraged that you had IMRT for breast radiation so long ago. Why did they choose that for you? What facility did you use?

thanks!
Val

I completed IMRT last feb 2004. I also had left mastectomy, am slender and received A/C f/b taxol. I was worried about the radiation being so close to the heart and also the effects of the adriamycin. I did not receive Herceptin until Nov 2005 though. The rad onc did not even mention IMRT until I questioned it. I was lucky because another hospital in my city offered this rx ( U MASS MEMORIAL HOSPITAL WORCESTER, MASSACHUSETTS). Continue to be your on advocate and fight the system for what you believe to be best for you! So far all mt echos have been normal. lorri

Hi Val,

I live in Alaska and my surgeon and oncologist are in Seattle.

By a wisdom greater than my own, my sister happens to work very close to where the new cancer treatment facility was being built in California. When I contacted them they discussed IMRT with me, and after looking into it further that is where I chose to go. In my case since I had a lumpectomy I would have preferred to have brachytherapy (seed implants) but was unsuccessful in connecting with a clinical trial for that.

By that same wisdom it happened that I was the patient of a very caring rads onc there. One unfortunate aspect is that I did end up with fatty necrosis of a part of the breast.

The facility I went to was the Enloe Cancer Center in Chico, California.

AlaskaAngel