Hypofractionated Whole-Breast Irradiation in Large-Breasted Women—Is There a Dosimetric Predictor for Acute Skin Toxicities?

Patel, Ankur; Ling, Diane C.; Richman, Adam H.; Champ, Colin E.; Huq, M. Saiful; Heron, Dwight E.; Beriwal, Sushil

doi:10.1016/j.ijrobp.2018.08.024

Cited by 28 publications

(20 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…RT with boost to all lumpectomy sites was very well tolerated. Only 3% of patients experienced grade 3 or higher acute dermatitis, and only 3.6% reported poor cosmesis, which compares quite favorably with the toxicity reported after RT for unifocal disease [24][25][26][27] . As expected, increasing radiation boost volume was associated with increased incidence of acute dermatitis, but importantly was not associated with worse overall cosmesis.…”

Section: Discussionmentioning

confidence: 61%

The Feasibility of Radiation Therapy after Breast-Conserving Surgery for Multiple Ipsilateral Breast Cancer: An Initial Report from ACOSOG Z11102 (Alliance) Trial

Cuttino

McCall

Kubicky

et al. 2022

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 61%

The Feasibility of Radiation Therapy after Breast-Conserving Surgery for Multiple Ipsilateral Breast Cancer: An Initial Report from ACOSOG Z11102 (Alliance) Trial

Cuttino

McCall

Kubicky

et al. 2022

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

“…The V105% is significantly correlated with higher probability of developing skin toxicity (43). The V 105% of the whole breast PTV should be less than 10% to keep grade 3 dermatitis rates below 2%.…”

Section: Discussionmentioning

confidence: 99%

The Composite Planning Technique in Left Sided Breast Cancer Radiotherapy: A Dosimetric Study

Kumawat¹,

Shrotriya²,

Heigrujam³

et al. 2020

Eur J Breast Health

View full text Add to dashboard Cite

Breast cancer or carcinoma of the breast (Ca-Breast) is the most common malignancy among women and the second most commonly occurring cancer overall in the world (1). In breast cancer, the most common treatment is conservative surgery or mastectomy followed by adjuvant chemotherapy and radiotherapy with or without hormonal therapy (2). Several prospective studies have shown that radiotherapy in Ca-Breast improved the disease free survival by almost 15% at 10 years and reduced the15-year risk of Ca-Breast death by 4% (3). Thus making the chronic sequelae of the breast cancer radiotherapy more important (4). But it has been shown that patients treated with radiation to chest wall or breast alone developed pneumonitis in 1% cases which increased to 4% in patients treated with loco-regional irradiation including draining lymph node (5).Oie et al. ( 6) reported that radiation pneumonitis (RP) mostly developed in ipsilateral lung and arose next to the rapidly decreasing dose area. Previous reports have shown that irradiation of the breast/chest wall with supraclavicular field led to an increased incidence of symptomatic radiation pneumonitis (7, 8) (SRP). Wen et al. ( 9) have suggested that the volume receiving 20Gy and 30Gy (V 20Gy , V 30Gy ) were

show abstract

“…Hypofractionation is indicated in patients who have undergone breast-conserving surgery, including for histology that is exclusively carcinoma in situ Recommendation: conditional Quality of evidence: low Degree of consensus: 72% Justification Despite the low quality of evidence, the same criteria were applied to hypofractionated radiotherapy for pure carcinoma in situ as to invasive tumours, pending results from an ongoing RCT (RTOG 9804) that specifically assesses this question [20] 10. Hypofractionation is indicated in patients who have undergone breast-conserving surgery, regardless of the size of the breast* Recommendation: strong Quality of evidence: high Degree of consensus: 95% Justification State-of-the-art technologies allow a greater homogeneity of the dose, so increasing the dose per fraction would imply that the size of the breast is irrelevant [22][23][24] has also been observed by other authors, for example Gilbo et al [29], who observed an improvement in utilisation rates from 49 to 80% in the 4 years following dissemination of the ASTRO guidelines, implementation of clinical practice directives, and follow-up through departmental discussions about clinical indications. As Recht commented in an editorial [30], the use of hypofractionation will only reach recommended levels if specialists are engaged and adherence to guidelines is monitored.…”

Section: Tablementioning

confidence: 99%

Evidence-based guidelines for hypofractionated radiation in breast cancer: conclusions of the Catalan expert working group

et al. 2022

View full text Add to dashboard Cite

Introduction Daily, moderate hypofractionation has become standard treatment for breast cancer following breast-conserving surgery, although substantial variation exists in its use. This paper describes the generation of consensus-based recommendations for the utilisation of this therapy at the healthcare system level and compares these to American Society for Radiation Oncology (ASTRO) guidelines. Materials and methods Consensus-based guidelines were developed in three steps, including a systematic literature review and involvement of radiation oncologists specialising in breast cancer in Catalonia: (a) creation of a working group and evidence review; (b) consideration of the levels of evidence and agreement on the formulation of survey questions; and (c) performance of survey and development of consensus-based recommendations. Results were compared to the ASTRO recommendations. Results Consensus was above 80% for 10 of the 14 survey items. Experts supported hypofractionated radiotherapy for all breast cancer patients aged 40 years or more; with invasive carcinoma and breast-conserving surgery; without radiation of lymph nodes; and regardless of the tumour size, histological grade, molecular subtype, breast size, laterality, other treatment characteristics, or need for a boost. Over half favoured its use in all situations, even where available scientific evidence is insufficient. The resulting recommendations and the quality of the evidence are comparable to those from ASTRO, despite some differences in the degree of consensus. Conclusion Specialists agree that hypofractionation is the standard treatment for breast cancer following breast-conserving surgery, but some specific areas require a higher level of evidence before unequivocally extending indications.

show abstract

Hypofractionated Whole-Breast Irradiation in Large-Breasted Women—Is There a Dosimetric Predictor for Acute Skin Toxicities?

Cited by 28 publications

References 20 publications

The Feasibility of Radiation Therapy after Breast-Conserving Surgery for Multiple Ipsilateral Breast Cancer: An Initial Report from ACOSOG Z11102 (Alliance) Trial

The Feasibility of Radiation Therapy after Breast-Conserving Surgery for Multiple Ipsilateral Breast Cancer: An Initial Report from ACOSOG Z11102 (Alliance) Trial

The Composite Planning Technique in Left Sided Breast Cancer Radiotherapy: A Dosimetric Study

Evidence-based guidelines for hypofractionated radiation in breast cancer: conclusions of the Catalan expert working group

Contact Info

Product

Resources

About