Cancer Research and Treatment

Original Articles

A Phase I/II Trial to Evaluate the Safety and Efficacy of Continuous Positive Airway Pressure in Volumetric Modulated Arc Therapy for Breast Cancer: Jung Bin Park, Tosol Yu, Jaeman Son, Chul-Won Choi, Seho Kwon, Hyun-Woo Shin, Hak Jae Kim, Ji Hyun Chang; Received November 22, 2025 Accepted January 25, 2026 Published online January 26, 2026; DOI: https://doi.org/10.4143/crt.2025.1281 [Accepted]

Abstract PDF: Purpose
This phase I/II study aimed to evaluate the tolerability and the organ-sparing effects of continuous positive airway pressure (CPAP) in breast cancer radiotherapy (RT).
Materials and Methods
We conducted a prospective, single-institutional trial approved by the Ministry of Food and Drug Safety of South Korea. Patients with breast cancer who received postoperative RT underwent 4D-CT simulation and treatment planning under both free breathing (FB) and CPAP-assisted breathing (WC), with a target pressure of 20 cm H₂O. Adverse events (AEs) were evaluated, and dosimetric parameters of organs at risk and heart position change were compared between the FB and WC arms.
Results
Among 20 enrolled patients, four withdrew due to discomfort during simulation. During the trial, no CPAP-related AEs greater than grade 2 were observed. Compared to FB, CPAP reduced the mean heart dose by 33.8% (p < 0.001), as well as V₅–V₃₀ for both the left ventricle and left anterior descending artery (all p < 0.05). It also led to significant reductions in V₅–V₄₀ and the mean ipsilateral lung dose, including a 4.4% reduction in V₂₀ (all p < 0.001). The heart centroid shifted rightward (4.8 mm), ventrally (8.1 mm), and caudally (16.3 mm) with CPAP, displacing the heart away from the RT field.
Conclusion
CPAP demonstrated both safety and efficacy for breast cancer RT, achieving significant reductions in cardiac and pulmonary radiation exposure. These findings support further investigation of CPAP as a novel respiratory motion management strategy. Future studies are warranted to identify optimal CPAP pressure levels to facilitate broader clinical implementation.

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Objective Measurement of Cosmetic Outcomes of Breast Conserving Therapy Using BCCT.core: Tosol Yu, Keun-Yong Eom, Na Young Jang, Kyung Su Kim, Tae Ryool Koo, Jeanny Kwon, Byoung Hyuck Kim, Eunyoung Kang, Sung-Won Kim, Jae-Sung Kim, In Ah Kim; Cancer Res Treat. 2016;48(2):491-498. Published online June 22, 2015; DOI: https://doi.org/10.4143/crt.2015.088

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study is to evaluate objective cosmetic outcomes and factors related to breast-conserving therapy (BCT) using the BCCT.core software.
Materials and Methods
Fifty-one patients who received BCT with informed consent were evaluated using the BCCT.core software. Patients were divided into two groups based on the BCCT score: excellent or good (n=42) vs. fair or poor (n=9). Analysis of clinical factors was performed to determine factors affecting cosmetic outcomes.
Results
The objective cosmetic outcome of BCT measured using the BCCT.core software was excellent in 10% of patients, good in 72%, and fair in 18%. None of the patients were classified as poor outcome. Tumor characteristics, systemic adjuvant therapy (chemotherapy and hormonal therapy), and radiation dose or energy of electron boost did not show correlation with the score measured by the BCCT.core program (p > 0.05). In univariate analysis, maximum dose within the breast (Dmax), width of tangential field, and excised tumor volume were smaller in patients with excellent or good by the BCCT.core compared to those with fair or poor (Dmax, 110.2±1.5% vs. 111.6±1.7%, p=0.019; width of tangential field, 8.0±1.1 cm vs. 8.6±0.7 cm, p=0.034; excised tumor volume, 64.0±35.8 cm3 vs. 95.3±54.4 cm3, p=0.067). In multivariate analysis, only Dmax was a significant factor for breast cosmetic outcome with a risk ratio of 1.697 (95% confidence interval, 1.006 to 2.863; p=0.047).
Conclusion
Objective measurement of cosmetic outcome of BCT using the BCCT.core software was feasible. The cosmetic outcome of BCT may be affected by the maximum dose within the breast.

Citations

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