Cosmesis in patients with breast neoplasia submitted to the hypofractionated radiotherapy with of intensity-modulated beam

Abstract

SUMMARY OBJECTIVE: To assess the cosmetic satisfaction of patients diagnosed with breast cancer submitted to the hypofractionated radiotherapy with IMRT (hIMRT) technique and its correlation with dosimetric data of the radiotherapy planning. MATERIALS AND METHODS: The retrospective cohort study that assessed women with a diagnosis of malignant breast neoplasia submitted to the conservative treatment or radical mastectomy and treated with hIMRT. In the period between August 2007 to December 2014, in a philanthropic / private institution, 170 records were selected. The cosmetic assessment was carried out by means of the Harvard/RTOG/NSABP scale with one-year minimum range after treatment. The collected dosimetric data were: breast / chest wall volume, volume that received 95% (V95%) and 107% (V107%) of the prescribed dose. RESULTS: The volume of the treated breasts ranged from 169 to 2.103 ml (median = 702; IQR: 535 to 914 ml). Median V95% was 86.7% (54.6-96.6%; IQR: 80.0% to 90.6%); eight (5.7%) patients had V95% higher than 95%. Median V107% was 0% (0%-16.3%; IQR: 0.0% to 0.3% and 13); 9.3% patients had V107% higher than 2%. One hundred and thirty-three (78.2%) patients responded to the cosmetic assessment: 99 (74.4%) considered the cosmetic results excellent. Significant associations between cosmetic assessment and breast volume (p=0.875), V95% (p=0.294) e V107% (p=0.301) were not found. CONCLUSION: The cosmetic results showed favorable when using hIMRT, and the lack of correlation with usual the dosimetric data illustrates the capacity of hIMRT to minimize the heterogeneity of the dose in this endpoint, even in voluminous breasts.

The use of moderately hypofractionated post-operative radiation therapy for breast cancer in clinical practice: A critical review

“…This concept is accepted in some countries, including the Netherlands and the UK, where moderate hypofractionation has been the standard for practically all indications of RT in breast-cancer patients for many years [ 35 , 39 , 40 ]. The results of prospectively collected databases and other real-life retrospective studies confirm that hypofractionated RT, with or without regional nodal irradiation, is safe, well-tolerated, and associated with satisfactory local control rates [ [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] ].…”

Moderately hypofractionated post-operative radiation therapy for breast cancer: Preferences amongst radiation oncologists from countries in Latin America and the Caribbean

“…Thus, the hypothesis of contemporary homogeneously delivered volume-based radiation therapy techniques can be applied to understanding that treatment effects should be undistinguishable regardless of the target volumes. Data from prospective and retrospective studies also showed that hypofractionated postmastectomy radiation therapy with or without regional nodal irradiation is safe, with low rates of side effects and suitable local control results [22,37,[39][40][41][42][43][44][45][46][47][48].…”

Elaboração de um protocolo fisioterapêutico para mulheres em radioterapia para o câncer de mama

“…Tabela 14 -Nota correspondente para Q 10 a Q13 e Q15 a Q19. (Ewertz et al, 2011;Leclerc et al ., 2016;Miranda et al, 2018;Neil-Sztramko et al, 2014;Rebegea et al, 2015;Shah et al, 2016;Vieira et al, 2015 (Scaffidi et al, 2012;Lu et al, 2015;Kim et al, 2010;Glowacka-Mrotek et al, 2018).…”