TY - JOUR
T1 - Hypofractionated postmastectomy radiotherapy with helical tomotherapy in patients with immediate breast reconstruction
T2 - dosimetric results and acute/intermediate toxicity evaluation
AU - Orecchia, Roberto
AU - Rojas, Damaris Patricia
AU - Cattani, Federica
AU - Ricotti, Rosalinda
AU - Santoro, Luigi
AU - Morra, Anna
AU - Cambria, Raffaella
AU - Luraschi, Rosa
AU - Dicuonzo, Samantha
AU - Ronchi, Sara
AU - Surgo, Alessia
AU - Dell’ Acqua, Veronica
AU - Veronesi, Paolo
AU - De Lorenzi, Francesca
AU - Fodor, Cristiana
AU - Leonardi, Maria Cristina
AU - Jereczek-Fossa, Barbara Alicja
PY - 2018/3/1
Y1 - 2018/3/1
N2 - The aim of this study was to evaluate the dosimetry and toxicity of hypofractionation in postmastectomy radiotherapy (PMRT) with intensity-modulated radiotherapy (IMRT) in breast cancer (BC) patients. Stage II–III BC patients with implant-based immediate breast reconstruction received PMRT to the chest wall (CW) and to the infra/supraclavicular nodal region (NR) using a 15-fraction schedule (2.67 Gy/fraction) and helical IMRT (Tomotherapy® System, Accuray Incorporated, Sunnyvale, CA). A score was assigned to each treatment plan in terms of planning target volume (PTV) coverage of CW and NR and the sparing of the organs at risk (OARs). The total score for each plan was calculated. Toxicity was prospectively assessed according to validated scales. Data from 120 consecutive patients treated in the period 2012–2015 were analysed with a median follow-up from the end of radiotherapy of 13.2 months (range 0.0–35 months). 70.8% (85/120) of the plans had high total scores as a result of an optimal coverage of both CW and RN and optimal sparing of all OARs. The maximum acute toxicity was of grade 2 in 36.7% of the cases. Early late toxicity was mild in the majority of cases. In the study population, helical tomotherapy-based IMRT produced optimal treatment plans in most cases. Acute and late toxicity was mild/moderate. Hypofractionated helical IMRT appears to be safe and feasible in the moderate term for PMRT.
AB - The aim of this study was to evaluate the dosimetry and toxicity of hypofractionation in postmastectomy radiotherapy (PMRT) with intensity-modulated radiotherapy (IMRT) in breast cancer (BC) patients. Stage II–III BC patients with implant-based immediate breast reconstruction received PMRT to the chest wall (CW) and to the infra/supraclavicular nodal region (NR) using a 15-fraction schedule (2.67 Gy/fraction) and helical IMRT (Tomotherapy® System, Accuray Incorporated, Sunnyvale, CA). A score was assigned to each treatment plan in terms of planning target volume (PTV) coverage of CW and NR and the sparing of the organs at risk (OARs). The total score for each plan was calculated. Toxicity was prospectively assessed according to validated scales. Data from 120 consecutive patients treated in the period 2012–2015 were analysed with a median follow-up from the end of radiotherapy of 13.2 months (range 0.0–35 months). 70.8% (85/120) of the plans had high total scores as a result of an optimal coverage of both CW and RN and optimal sparing of all OARs. The maximum acute toxicity was of grade 2 in 36.7% of the cases. Early late toxicity was mild in the majority of cases. In the study population, helical tomotherapy-based IMRT produced optimal treatment plans in most cases. Acute and late toxicity was mild/moderate. Hypofractionated helical IMRT appears to be safe and feasible in the moderate term for PMRT.
KW - Hypofractionation
KW - Immediate breast reconstruction
KW - Locoregional radiotherapy
KW - Tomotherapy
KW - Toxicity
UR - http://www.scopus.com/inward/record.url?scp=85042081435&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85042081435&partnerID=8YFLogxK
U2 - 10.1007/s12032-018-1095-6
DO - 10.1007/s12032-018-1095-6
M3 - Article
AN - SCOPUS:85042081435
VL - 35
JO - Medical Oncology
JF - Medical Oncology
SN - 1357-0560
IS - 3
M1 - 39
ER -