Comparative retrospective analysis of locoregional recurrence in unselected breast cancer patients treated with conventional versus hypofractionated radiotherapy at a tertiary cancer center?

Yadav, Rajanikant R; Lal, Punita; Agarwal, Sushma; Misra, Shagun; Verma, Mranalini; Daş, Koray; Kumar, Sanjeev; Kumar, Anup; Mishra, Sonam; Agarwal, Amit Kumar; Agarwal, Gaurav; Mishra, Anjali; Chand, Gyan; Verma, Ashish; Kumar, Shaleen

doi:10.4103/jcrt.jcrt_389_18

Cited by 5 publications

(3 citation statements)

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“…[22] The severity of ARD is most relevant to the treatment plan, and is associated with the irradiated skin area, the total radiation dose, the fractional dose, and the RT technique. [23][24][25][26] Additional factors include hygiene, clothing and diet, individual patient conditions such as diabetes, skin diseases, obesity, and remaining treatment during RT. [11] Unlike previous studies, there was no signi cant correlation between the BMI and BSA of patients, and the occurrence and severity of ARD in the present study, which was likely related to the fact that post-radical surgery patients were enrolled in the study, and the relationship between irradiated volume and BMI and BSA was not clear.…”

Section: Discussionmentioning

confidence: 99%

Dose-volume predictors of radiation dermatitis in patients undergoing radiotherapy after radical mastectomy for breast cancer

han,

zhang,

et al. 2024

Preprint

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Purpose To analyze incidence and dose-volume predictors of acute radiation dermatitis (ARD) in patients with breast cancer who undergo regional nodal irradiation. Methods and materials: Patients treated with Intensity-modulated radiation therapy (IMRT) in the chest wall, supraclavicular/subclavicular fossa, secondary axilla, and/or intramammary link after mastectomy were included. The prescribed dose was 50 Gy in 25 fractions. ARD was evaluated and graded once during radiotherapy(RT), 1 week after RT, and at the 1 month follow-up. Grading was performed according to the National Cancer Institute Common Toxicity Criteria for Adverse Events version 3.0. Total skin volume, mean dose, maximum dose, relative volume (RV5-RV45) and absolute volume (AV5-AV45) in patients receiving at least 5 to 45 Gy in 5 Gy increments were assessed. Univariate and multivariate logistic regression analyses were performed to identify risk factors for ARD and to obtain ROC curves. Thresholds for skin dosimetry parameters were determined. Results A total of 134 patients with breast cancer who received recruited RT were included in this analysis. Among all patients the incidence of ≥ 2 ARD was 33.58% (45/134), of which the incidence of grade 2 ARD was 32.09% (43/134), and the incidence of grade 3 RD was 1.49% (2/134). No grade 4 or 5 ARD was observed. After univariate and multivariate analyses, age, BMI, BSA, sex, tumor laterality, vascular cancer embolus, nerve invasion, adjuvant chemotherapy were not significantly associated with the risk of grade ≥ 2 ARD. Internal mammary nodal irradiation (IMNI) (P = 0.049) and targeted therapy (P = 0.005) were independent risk factors for ARD. AV35 (P = 0.030) and AV40 (P = 0.025)of the skin were significantly associated with the risk of grade ≥ 2 RD. According to the ROC curves, the optimum thresholds were 199 mL for AV35 and 181.8 mL for AV40, respectively. Conclusion The receipt of targeted therapy during radiation therapy and IMNI are risk factors for the development of grade 2 ARD. Maintaining AV35 on the upper skin at < 199 mL and AV40 at < 181.8 mL may decrease the risk of ARD.

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Section: Discussionmentioning

confidence: 99%

Dose-volume predictors of radiation dermatitis in patients undergoing radiotherapy after radical mastectomy for breast cancer

han,

zhang,

et al. 2024

Preprint

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“…In our country, women more often present with LO/LABC [6]. Though we have reported the safety and e cacy of HF-WBI in LO/LABC, cosmetic outcome and late-effects analysis had not yet been conducted [5]. Hence we conducted a crosssectional study of women who underwent BCS during a 5 year period with at least 3 years follow-up, to ascertain the CA and LE in arm and shoulder and PROM.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, the recent update of the American Society of Radiation Oncology (ASTRO) evidence-based guidelines on radiation therapy for the whole breast con rmed that HF-WBI represents the preferred option for patients with early-stage breast cancer, regardless of age, chemotherapy administration and breast size and recommends minimization of breast volume receiving >105% of the prescription dose [3]. Real world data have con rmed the safety and e cacy of hypo-fractionated RT in early BC and LABC in various studies [4,5]. Cosmesis is an important endpoint of successful implementation of breast conservation.…”

Section: Introductionmentioning

confidence: 99%

Factors predicting Cosmesis (CA), Late effects (LE) and Patient reported outcome measures (PROM) in high-risk breast cancer (BC) treated with hypo-fractionated radiotherapy (HF-WBI): real world outcomes from a developing country

Mishra#,

Agrawal#,

Lal#

et al. 2024

Preprint

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Introduction: Literature on cosmesis in large operable (LO) and locally advanced breast cancer (LABC) is sparse, so we investigated the cosmesis, LE and PROM and factors affecting it in this subset. Materials and Methods: BC with upfront BCS or after neoadjuvant chemotherapy (NACT) underwent physical CA, LE and PROM using EORTC, RTOG and BR23 questionnaire respectively. Patient, tumour and treatment related factors were correlated with CA, LE and PROM by univariate and multivariate analysis. Results: 186 women underwent BCS, but only 82 could participate due to Covid. Prevalence of high-risk features were found: >3cm tumour in 37%, 50% node positive, 100% received CT, grade 3 in 57%, Her-2/TNBC in 70%. At a median follow-up of 5 years, we found that 56% patients had adverse global cosmesis. Factors responsible for adverse cosmesis were tumour size [> 3 cm, HR 2.3], node positivity [HR 0.3], receipt of CT [HR 6.5], large resection volumes [HR 4.6], large breast volume [HR 1], supraclavicular RT in 43% [HR 0.7]. Dosimetric factors found significant for adverse cosmesis were breast volume receiving 107% dose (> than 10cc, HR 5) and breast volume receiving 100% dose (> than 120cc, HR 5). The incidence of arm oedema was 6%, shoulder stiffness 20%, brachial plexopathy 4% and factors significant for LE were tumour size > 3cm [HR 9], breast volume receiving 107% [HR 6], and co-morbidity [HR 3]. 69% had poor body image, 35% breast pain, 47% were sexually active. Conclusion: BC with LO/LABC and high-risk features had adverse cosmesis in 56% women.

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Cardiac dose reduction using deep inspiratory breath hold (DIBH) in radiation treatment of left sided breast cancer patients with breast conservation surgery and modified radical mastectomy

Misra

Mishra

Lal

et al. 2021

Journal of Medical Imaging and Radiation Sciences

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Comparative retrospective analysis of locoregional recurrence in unselected breast cancer patients treated with conventional versus hypofractionated radiotherapy at a tertiary cancer center?

Cited by 5 publications

References 0 publications

Dose-volume predictors of radiation dermatitis in patients undergoing radiotherapy after radical mastectomy for breast cancer

Dose-volume predictors of radiation dermatitis in patients undergoing radiotherapy after radical mastectomy for breast cancer

Factors predicting Cosmesis (CA), Late effects (LE) and Patient reported outcome measures (PROM) in high-risk breast cancer (BC) treated with hypo-fractionated radiotherapy (HF-WBI): real world outcomes from a developing country

Cardiac dose reduction using deep inspiratory breath hold (DIBH) in radiation treatment of left sided breast cancer patients with breast conservation surgery and modified radical mastectomy

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