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01.03.2018 | Original Paper | Ausgabe 3/2018

Medical Oncology 3/2018

Hypofractionated postmastectomy radiotherapy with helical tomotherapy in patients with immediate breast reconstruction: dosimetric results and acute/intermediate toxicity evaluation

Zeitschrift:
Medical Oncology > Ausgabe 3/2018
Autoren:
Roberto Orecchia, Damaris Patricia Rojas, Federica Cattani, Rosalinda Ricotti, Luigi Santoro, Anna Morra, Raffaella Cambria, Rosa Luraschi, Samantha Dicuonzo, Sara Ronchi, Alessia Surgo, Veronica Dell’ Acqua, Paolo Veronesi, Francesca De Lorenzi, Cristiana Fodor, Maria Cristina Leonardi, Barbara Alicja Jereczek-Fossa
Wichtige Hinweise
Rosalinda Ricotti, Luigi Santoro, Sara Ronchi—Affiliated with European Institute of Oncology at the time of the study.
Roberto Orecchia and Damaris Patricia Rojas: Co-first authors: these authors equally contributed to the work and thus should be considered as co-first authors.
Maria Cristina Leonardi and Barbara Alicja Jereczek-Fossa: Co-last authors: these authors equally contributed to the work and thus should be considered as co-last authors.

Abstract

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.

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