Early Experience of Tomotherapy-based Intensity-modulated Radiotherapy for Breast Cancer Treatment

Intensity modulated radiotherapy (IMRT) with simultaneous integrated boost (SIB) in a patient with left breast cancer and pectus excavatum

“…sequential electron boost plan, not only allowed us to decrease the dose constraints for ipsilateral lung and heart (and consequently the NTCPs), but also to reduce the overall treatment time from 6 to 5 weeks. These dosimetric outcomes are consistent with previous reports [19,20], which added to the proven clinical benefits of IMRT in the adjuvant treatment of breast cancer patients with complex treatment volumes has conduced to establish IMRT as a standard treatment [21].…”

“…However, some clinical situations such as bilateral irradiation for synchronic bilateral tumors, irradiation of a big breast volume, voluminous contralateral breast/prosthesis, cardiomegaly, or the presence of an associated pectus excavatum still represent a challenge for a safe adjuvant radiation treatment. These patients benefit of a more complex radiation technique [6,7].…”

Effect of Breast Volume on Treatment Reproducibility on a Tomotherapy Unit in the Treatment of Breast Cancer

“…Recently, several groups have published data showing better dose conformality and homogeneity as well as better coverage of the planning target volume (PTV) with helical tomotherapy as compared with standard three-dimensional conformal multifield techniques for treating breast cancer (4)(5)(6). These studies have also demonstrated better sparing of critical structures such as heart, lung, and soft tissue from high doses at the expense of a greater volume of tissue exposed to a low dose of radiation.…”

Helical tomotherapy in patients with breast cancer and complex treatment volumes

“…We will continue to gain experience in tomotherapy treatment for patients with complex treatment volumes, until it becomes a more widely available technique and it can be offered to patients without any special conditions. Meanwhile, considering the dosimetric advantages, it is likely that early clinical experience with tomotherapy be restricted to patients with special characteristics [40]. Independently from the availability of local technology, the subset of women who are at greatest risk from normal tissue morbidity or reduced cosmesis should be accurately defi ned in order to enable a referral system capable of offering these patients a high technology approach, whilst allowing the optimal use of resources [41].…”