Acute and intermediate toxicity of 3-week radiotherapy with simultaneous integrated boost using TomoDirect: prospective series of 287 early breast cancer patients

Dicuonzo, Samantha; Leonardi, Maria Cristina; Raimondi, Sara; Corrao, Giulia; Bagnardi, Vincenzo; Gerardi, M.A.; Morra, Anna; Zerella, Maria Alessia; Zaffaroni, Mattia; Pansini, F.; Cattani, Federica; Luraschi, R.; Fodor, C.; Veronesi, Giulia; Orecchia, Roberto; Rojas, Damaris Patricia; Jereczek-Fossa, Barbara A.

doi:10.1007/s12094-020-02538-w

Cited by 3 publications

(7 citation statements)

References 46 publications

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“…Few clinical studies have yet to evaluate the feasibility of the SIB technique in patients treated with HT [ 13 , 15 , 25 , 26 ], and with other modern RT techniques [ 27 – 29 ]. In a randomized trial comparing conventional RT and hypofractionated RT using HT with the SIB technique, van Parijs et al displayed the feasibility and safety of the HT with SIB technique compared to conventional RT [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, HT has shown superiority with absence of higher doses in standard boost plan, and significantly lower HI compared to VMAT in SB and SIB plans, which potentially reduces the risk of breast fibrosis. Few clinical studies have yet to evaluate the feasibility of the SIB technique in patients treated with HT [13,15,25,26], and with other modern RT techniques [27][28][29]. In a randomized trial comparing conventional RT and hypofractionated RT using HT with the SIB technique, van Parijs et al displayed the feasibility and safety of the HT with SIB technique compared to conventional RT [26].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of helical and TomoDirect techniques with simultaneous integrated boost in early breast cancer patients

Onal,

Bozca,

Oymak

et al. 2023

Rep Pract Oncol Radiother.

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Background The aim of the study was to perform dosimetric comparisons of helical (H) and TomoDirect (TD) plans for whole-breast irradiation (WBI) with simultaneous integrated boost (SIB) in early-stage breast cancer patients undergoing breast conserving surgery. Materials and methods Fifty patients, 25 with left-side and 25 with right-side tumors, were determined for a treatment planning system for a total dose of 50.4Gy in 1.8Gy per fraction to WBI, with a SIB of 2.3Gy per fraction delivered to the tumor bed. The planning target volume (PTV) doses and the conformity (CI) and homogeneity indices (HI) for PTV breast and PTV boost , as well as organ-at-risk (OAR) doses and treatment times, were compared between the H and TD plans. Results All plans met the PTV coverage criteria for the H plan, except for mean V107 of PTV breast for TD plan. The H plan yielded better homogeneity and conformity of dose distribution compared to the TD plan. The ipsilateral mean lung doses were not significantly different between the two plans. The TD plans is advantageous for mean doses to the heart, contralateral breast and lung, spinal cord, and esophagus than the H plans. In both the H and TD plans, the right-sided breast patients had lower heart dose parameters than the left-sided breast patients. The TD plan is superior to the H plan in sparing the contralateral breast and lung by decreasing low-dose volumes. Conclusions While the OAR dose advantages of TD are appealing, shorter treatment times or improved dose homogeneity and conformity for target volume may be advantageous for H plan.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of helical and TomoDirect techniques with simultaneous integrated boost in early breast cancer patients

Onal,

Bozca,

Oymak

et al. 2023

Rep Pract Oncol Radiother.

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“…A number of studies have reported a relationship between the risk of RP and dosimetric parameters, including total radiation dose, fractionation, mean lung dose and irradiated lung volume, such as V 5 , V 10 , V 20 , and V 30 ( 22 , 24 , 25 ). Advanced techniques, such as IMRT, VMAT and helical tomotherapy, can improve dosimetry and reduce acute toxicities through the RT planning process ( 26 , 27 ); thus, they are also useful in HFX-RT. In the present study, irradiated lung volume was restricted to reduce the risk of RP.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the focus of the current study on HFX–VMAT is novel and provides convincing data for the literature. The data on long-term follow-up after HFX-RT in EBC is lacking, especially for IMRT, including VMAT, despite reports of late toxicity, such as fibrosis and secondary malignancy ( 7 , 26 , 27 , 32 , 37 ). Further research would be helpful in identifying the long-term treatment outcomes after HFX-RT in EBC.…”

Section: Discussionmentioning

confidence: 99%

Safety of hypofractionated volumetric modulated arc therapy for early breast cancer: A preliminary report

Lee

Chung

2023

Oncol Lett

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The present study attempts to evaluate the acute and subacute toxicities of hypofractionated volumetric modulated arc therapy (HFX–VMAT) in patients with early breast cancer (EBC). It is a retrospective analysis of 23 patients treated with HFX–VMAT after breast-conserving surgery between September 2021 and February 2022. A total dose of 50.05 to 52.55 Gy was delivered, consisting of 40.05 Gy to the ipsilateral whole breast in 15 fractions of 2.67 Gy and a tumor bed boost dose of 10–12.5 Gy in 4–5 fractions. The primary endpoint was acute/subacute radiation pneumonitis (RP). The secondary endpoint was poor cosmesis, indicating acute/subacute radiation dermatitis. Chest computed tomography (CT) and the Common Terminology Criteria for Adverse Events v.5.0 were used to assess acute and subacute RP and dermatitis, respectively, during radiotherapy (RT) and at 3- and 6-months post-RT. The median follow-up duration was 3.8 months (range, 2.3-4.2). A total of seven patients developed RP. None of these patients presented RP-related symptoms; the diagnosis was based on radiologic findings observed on follow-up chest CT. Among the seven patients with RP, five had right-sided, and two had left-sided breast tumors (71.4 vs. 28.6%; P=0.026). Grade 1 erythema was observed in 19 patients (82.6%) and grade 2 erythema in four (17.4%). The mean target dose, D 105% (the dose received by 105% of the target volume), homogeneity index, mean lung dose, ipsilateral lung V 20 (the percentage volume receiving 20 Gy), and V 30 (the percentage volume receiving 30 Gy) for ipsilateral whole breast RT were significantly associated with RP (P=0.039, 0.047, 0.018, 0.015, 0.018 and 0.003, respectively.). HFX–VMAT showed tolerable acute/subacute toxicities. Therefore, HFX–VMAT is an effective and safe treatment option for EBC.

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“… 1 , 2 Apart from regular C-arm linear accelerators, static beam IMRT for patients with breast cancer can also be delivered with TomoDirect, an IMRT modality delivered with TomoTherapy (Accuray, Madison, WI). 3 , 4 , 5 , 6 …”

Section: Introductionmentioning

confidence: 99%

Machine Learning for Predicting Clinician Evaluation of Treatment Plans for Left-Sided Whole Breast Radiation Therapy

Fiandra¹,

Cattani²,

Leonardi³

et al. 2023

Advances in Radiation Oncology

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Acute and intermediate toxicity of 3-week radiotherapy with simultaneous integrated boost using TomoDirect: prospective series of 287 early breast cancer patients

Cited by 3 publications

References 46 publications

Comparison of helical and TomoDirect techniques with simultaneous integrated boost in early breast cancer patients

Comparison of helical and TomoDirect techniques with simultaneous integrated boost in early breast cancer patients

Safety of hypofractionated volumetric modulated arc therapy for early breast cancer: A preliminary report

Machine Learning for Predicting Clinician Evaluation of Treatment Plans for Left-Sided Whole Breast Radiation Therapy

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