ArticleClinical and translational radiation oncology2021
Selection criteria for early breast cancer patients in the DBCG proton trial - The randomised phase III trial strategy.
Article in Clinical and translational radiation oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Proton beam therapy indications in the Kingdom of Saudi Arabia: A SARO clinical practice guideline.Saudi medical journal · 2025Guideline
- Conventional versus hypofractionated postmastectomy proton radiotherapy in the USA (MC1631): a randomised phase 2 trial.The Lancet. Oncology · 2023Trial
- Cost-Effectiveness of Proton Therapy Compared With Photon Therapy in Breast Cancer.JAMA network open · 2026Article
- Patient perspectives on participation in the Danish Breast Cancer Group Proton Trial: A qualitative research study.Technical innovations & patient support in radiation oncology · 2025Review
- Cardiac Substructure Dose Reduction and Toxicity Risk Assessment: IMPT Versus IMRT for Breast Cancer.International journal of particle therapy · 2025Article
- Determinants of radiation dose to immune cells during breast radiotherapy.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2025Article
- Utilizing proton therapy to reduce health-care disparities among patients with breast cancers.JNCI cancer spectrum · 2025Article
- Case Report: Androgen receptor-positive, locoregionally advanced breast cancer in a transgender man and an update on breast cancer management in a gender-diverse patient population.Frontiers in oncology · 2025Article
- New guidelines and recommendations to advance treatment planning in proton therapy.Physics and imaging in radiation oncology · 2025Article
- Geometrical and dosimetrical evaluation of different interpretations of a european consensus delineation guideline for the internal mammary lymph node chain in breast cancer patients.Physics and imaging in radiation oncology · 2024Article
- Selection criteria and method for deep inspiration breath-hold in patients with left breast cancer undergoing PMRT/IMRT.Clinical and translational radiation oncology · 2024Article
- PTCOG international survey of practice patterns and trends in utilization of proton therapy for breast cancer.Clinical and translational radiation oncology · 2024Article
- Is the risk of ischemic heart disease in women after radiotherapy for breast cancer nowadays still (linearly) associated with the mean heart dose?Acta oncologica (Stockholm, Sweden) · 2024Article
- Review
- Spot-scanning proton therapy for early breast cancer in free breathing versus deep inspiration breath-hold.Acta oncologica (Stockholm, Sweden) · 2024Article
- Particle radiotherapy for breast cancer.Frontiers in oncology · 2023Review
- Particle Therapy for Breast Cancer.Cancers · 2022Review
- Radiation-Induced Toxicity Risks in Photon Versus Proton Therapy for Synchronous Bilateral Breast Cancer.International journal of particle therapy · 2022Article
- Proton Therapy for Breast Cancer: A Consensus Statement From the Particle Therapy Cooperative Group Breast Cancer Subcommittee.International journal of radiation oncology, biology, physics · 2021Review
- Dose constraints for whole breast radiation therapy based on the quality assessment of treatment plans in the randomised Danish breast cancer group (DBCG) HYPO trial.Clinical and translational radiation oncology · 2021Article
Corrections and comments
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Authors and funding
19 authors at 18 institutions in 6 countries.
Funding
Abstract
background and purposeAdjuvant radiotherapy of internal mammary nodes (IMN) improves survival in high-risk early breast cancer patients but inevitably leads to more dose to heart and lung. Target coverage is often compromised to meet heart/lung dose constraints. We estimate heart and lung dose when target coverage is not compromised in consecutive patients. These estimates are used to guide the choice of selection criteria for the randomised Danish Breast Cancer Group (DBCG) Proton Trial. MATERIALS AND
methods179 breast cancer patients already treated with loco-regional IMN radiotherapy from 18 European departments were included. If the clinically delivered treatment plan did not comply with defined target coverage requirements, the plan was modified retrospectively until sufficient coverage was reached. The choice of selection criteria was based on the estimated number of eligible patients for different heart and lung dose thresholds in combination with proton therapy capacity limitations and dose-response relationships for heart and lung.
resultsMedian mean heart dose was 3.0 Gy (range, 1.1-8.2 Gy) for left-sided and 1.4 Gy (0.4-11.5 Gy) for right-sided treatment plans. Median V17Gy/V20Gy (hypofractionated/normofractionated plans) for ipsilateral lung was 31% (9-57%). The DBCG Radiotherapy Committee chose mean heart dose ≥ 4 Gy and/or lung V17Gy/V20Gy ≥ 37% as thresholds for inclusion in the randomised trial. Using these thresholds, we estimate that 22% of patients requiring loco-regional IMN radiotherapy will be eligible for the trial.
conclusionThe patient selection criteria for the DBCG Proton Trial are mean heart dose ≥ 4 Gy and/or lung V17Gy/V20Gy ≥ 37%.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.