Modern Radiotherapy Era in Breast Cancer

Abstract

Radiation therapy (RT) is one of the major treatment modalities that are used in breast cancer treatment, and depending on the chest-wall anatomy, RT fields have to be customized. Techniques used in planning have been evolving since last two decades from two dimensional (2D) to three-dimensional (3D), while intensity modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT) and even proton therapy have been an option in daily approach. In addition, technological hardware and software advances in delivery and planning systems, total treatment duration of breast RT have been shortened in last decades along with recent hypofractionated radiotherapy schemes or emerging partial-breast irradiation protocols. The other attractive approach-accelerated partial breast irradiation (APBI) could be a reasonable option for highly selected subpopulation of early-stage breast cancer patients out of a clinical trial. Long-term follow-up results have emerged heart and coronary sparing with maximum safety and efficacy. The most important advance could be named as cardiac sparing-deep breathhold approach-in all the modern technique improvement. Although most advanced techniques in management of breast cancer have not been verified to increase survival, we suggest recommending resource stratified advanced in order to provide best technical and clinical care in this long-term survivor candidates.

Dosimetric and radiobiological comparison between conventional and hypofractionated breast treatment plans using the Halcyon system

“…A HI value close to zero means that the dose is homogeneously distributed in the PTV. Another one is the conformity index (CI), which is calculated as CI = (V RI for PTV) 2 100 Â oall organs (V RI for the i th organ)…”

A radiobiological comparison of hypo-fractionation versus conventional fractionation for breast cancer 3D-conformal radiation therapy

“…Such a long treatment schedule has major implications on both patient's compliance and department workload, especially in a country like Iran where workforce and resources are always a constraint. Lately, a task force principle has been published by the Radiation Oncology American Society, suggesting hypofractionated radiotherapy (HR) for all women at any age, whether they had had chemotherapy or not, over the past decades [1]. Studies from the United Kingdom and Canada supported their evidence-based suggestions.…”