Moderately hypofractionated radiation therapy for breast cancer: A Brazilian cohort study

Siqueira, Gabriela Silva Moreira de; Hanna, Samir Abdallah; Moura, Larissa F. de; Miranda, Fabiana Accioli; Carvalho, Heloísa de Andrade; Marta, Gustavo Nader

doi:10.1016/j.lana.2022.100323

Cited by 6 publications

(7 citation statements)

References 43 publications

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“…As it stands, conventional radiotherapy and low‐segment radiotherapy are the methodologies most prevalently implemented in clinical practice. Clinical studies have shown that the effect of hypofractionated radiotherapy is better than conventional radiotherapy, because hypofractionated radiotherapy can control the proliferation of cancer cells during the interval of radiographic exposure by increasing the radiation dose of local tumor tissue, thereby inhibiting the tumor growth 32–34 . Inspired by the results of this study, more and more clinical studies have begun to compare the effects of conventional radiotherapy and hypofractionated radiotherapy for BC.…”

Section: Neoadjuvant Radiotherapymentioning

confidence: 88%

“…Clinical studies have shown that the effect of hypofractionated radiotherapy is better than conventional radiotherapy, because hypofractionated radiotherapy can control the proliferation of cancer cells during the interval of radiographic exposure by increasing the radiation dose of local tumor tissue, thereby inhibiting the tumor growth. [32][33][34] Inspired by the results of this study, more and more clinical studies have begun to compare the effects of conventional radiotherapy and hypofractionated radiotherapy for BC. Most results suggest that the 3-year OS rate after hypofractionated radiotherapy is significantly higher than that after conventional radiotherapy.…”

Section: Preoperative Radiotherapy Regimen and Dosementioning

confidence: 99%

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Revolutionizing the battle against locally advanced breast cancer: A comprehensive insight into neoadjuvant radiotherapy

Kong,

Song,

Gao

et al. 2023

Medicinal Research Reviews

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Breast cancer (BC) constitutes one of the most pervasive malignancies affecting the female population. Despite progressive improvements in diagnostic and therapeutic technologies, leading to an increased detection of early stage BCs, locally advanced breast cancer (LABC) persists as a significant clinical challenge. Owing to its poor overall survival (OS) rate, elevated recurrence rate, and high potential for distant metastasis, LABC prominently impacts the comprehensive efficacy of BC treatments. Radiotherapy, encompassing preoperative, intraoperative, and postoperative modalities, is acknowledged as an effective strategy for mitigating BC metastasis and enhancing survival rates among patients. Nevertheless, the domain of preoperative neoadjuvant radiotherapy (NART) remains conspicuously underexplored in clinical studies. Available research suggests that NART can induce tumor volume reduction, provoke fibrotic changes in tumor and adjacent normal tissues, thereby mitigating intraoperative cancer propagation and enhancing the quality of life for LABC patients. This manuscript seeks to provide a review of contemporary research pertaining to LABC and its preoperative radiotherapy.

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Section: Neoadjuvant Radiotherapymentioning

confidence: 88%

Section: Preoperative Radiotherapy Regimen and Dosementioning

confidence: 99%

Revolutionizing the battle against locally advanced breast cancer: A comprehensive insight into neoadjuvant radiotherapy

Kong,

Song,

Gao

et al. 2023

Medicinal Research Reviews

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“…Moreover, the START trials' data demonstrated that the rates of ischemic heart disease and lung brosis are remarkably low (less than 2%) [33]. Even though these values can be higher than those noticed by other authors using modern diagnostic instruments, patients rarely developed symptoms consistent with pulmonary and cardiac side effects that required medical intervention [34][35][36][37].…”

Section: Discussionmentioning

confidence: 99%

“…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].…”

Section: Discussionmentioning

confidence: 99%

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

Marta

Franco

Carvalho

et al. 2022

Preprint

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Purpose The safety and effectiveness of moderately hypofractionated post-operative radiation therapy for breast cancer were demonstrated by several trials. This study aimed to evaluate the current patterns of practice and to assess possible aspects that affect the decision-making process regarding the use of fractionation in breast cancer patients in Latin America and the Caribbean (LAC). Methods Radiation oncologists from LAC were invited to contribute to this this study. A 38-question survey was used to evaluate their opinions. Results A total of 173 radiation oncologists from 13 countries answered the questionnaire. The majority of respondents (84.9%) preferred moderately hypofractionated post-operative radiation therapy as their first choice in cases of whole breast irradiation. For whole breast plus regional nodal irradiation, post-mastectomy (chest wall and regional nodal irradiation) without reconstruction, and post-mastectomy (chest wall and regional node irradiation) with reconstruction hypofractionated post-operative radiation therapy was preferred by 72.2% 71.1%, and 53.7% of respondents, respectively. Breast cancer stage, and flap-based breast reconstruction were the factors associated with absolute contraindications for the use of hypofractionated schedules. Conclusion Even though moderately hypofractionated post-operative radiation therapy for breast cancer is considered a new standard to the vast majority of the patients, its unrestricted application in clinical practice across LAC still faces reluctance.

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“…Breast cancer (BC) is the most frequently diagnosed and most frequent cause of cancer death in women worldwide [1]. Postoperative radiation therapy (RT) is part of the standard treatment for most patients diagnosed with BC with increase in local control, disease-free survival, and overall survival [2][3][4][5][6][7][8]. As patient survival increases, the long-term effects of RT become increasingly relevant.…”

Section: Introductionmentioning

confidence: 99%

Deep inspiration breath hold: dosimetric benefits to decrease cardiac dose during postoperative radiation therapy for breast cancer patients

Degrande,

Marta,

Alves

et al. 2023

Rep Pract Oncol Radiother.

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Background: Postoperative radiation therapy (RT) is the standard treatment for almost all patients diagnosed with breast cancer. Even with modern RT techniques, parts of the heart may still receive higher doses than those recommended by clinically validated dose limit restrictions, especially when the left breast is irradiated. Deep inspiration breath hold (DIBH) may reduce irradiated cardiac volume compared to free breathing (FB) treatment. This study aimed to evaluate the dosimetric impact on the heart and left anterior descending coronary artery (LAD) in FB and DIBH RT planning in patients with left breast cancer. Materials and methods:A retrospective cohort study of women diagnosed with left-sided breast cancer submitted to breast surgery followed by postoperative RT from 2015 to 2019. All patients were planned with FB and DIBH and hypofractionated dose prescription (40.05 Gy in 15 fractions).Results: 68 patients were included in the study. For the coverage of the planned target volume evaluation [planning target volume (PTV) eval] there was no significant difference between the DIBH versus FB planning. For the heart and LAD parameters, all constraints evaluated favored DIBH planning, with statistical significance. Regarding the heart, median V16.8 Gy was 2.56% in FB vs. 0% in DIBH (p < 0.001); median V8.8 Gy was 3.47% in FB vs. 0% in DIBH (p < 0.001) and the median of mean heart dose was 1.97 Gy in FB vs. 0.92 Gy in DIBH (p < 0.001). For the LAD constraints D2% < 42 Gy, the median dose was 34.87 Gy in FB versus 5.8 Gy in DIBH (p < 0.001); V16.8 Gy < 10%, the median was 15.87% in FB versus 0% in DIBH (p < 0.001) and the median of mean LAD dose was 8.13Gy in FB versus 2.92Gy in DIBH (p < 0.001). Conclusions:The DIBH technique has consistently demonstrated a significant dose reduction in the heart and LAD in all evaluated constraints, while keeping the same dose coverage in the PTV eval.

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Moderately hypofractionated radiation therapy for breast cancer: A Brazilian cohort study

Cited by 6 publications

References 43 publications

Revolutionizing the battle against locally advanced breast cancer: A comprehensive insight into neoadjuvant radiotherapy

Revolutionizing the battle against locally advanced breast cancer: A comprehensive insight into neoadjuvant radiotherapy

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

Deep inspiration breath hold: dosimetric benefits to decrease cardiac dose during postoperative radiation therapy for breast cancer patients

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