Side Effects Associated with the Use of Intensity-Modulated Radiation Therapy in Breast Cancer Patients Undergoing Adjuvant Radiation Therapy: A Systematic Review and Meta-Analysis

Jensen, Katherine E.; Soril, Lesley; Stelfox, Henry T.; Clement, Fiona; Lin, Yongtao; Marshall, Deborah A.

doi:10.1016/j.jmir.2017.09.002

Cited by 8 publications

(8 citation statements)

References 31 publications

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“…8 was proposed to detect and quantify breast swelling from the early stages prior to X-ray imaging. The procedure shall be applied on weekly basis in the absence of any correlation between swelling occurrence and time from the first fraction [7] . In line with local dosimetry margins for breast irradiations, if the oedema thickness exceeds 8 mm, patient treatment is stopped, physicians are alerted and shall decide on repeat simulation and dosimetry planning.…”

Section: Resultsmentioning

confidence: 99%

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Benchmarking the AlignRT surface deformation module for the early detection and quantification of oedema in breast cancer radiotherapy

Sorgato¹,

Ghazouani

Queffelec

et al. 2022

Technical Innovations & Patient Support in Radiation Oncolo

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Purpose To determine the accuracy of AlignRT surface deformation module in detecting and quantifying oedema in breast cancer radiotherapy. Materials and Methods A female torso phantom and water-equivalent boluses of different thicknesses (0.5–1.5 cm) were used. The variation of surface displacement and the percentage of surface within tolerance, as a function of bolus thickness and Region of Interest (ROI) size, were investigated. Additionally, a dynamic phantom was used to study the impact of patient breathing on the swelling estimation. Lastly, a flowchart was derived to alert physicians in the case of breast swelling. Results Average displacement value proved to be inversely correlated with ROI size (R 2 > 0.9). As such, for a ROI smaller than the bolus size (2.5x2.5 cm 2 ), the average displacement (1.05 cm) provides an accurate estimate of the oedema thickness (within 5%). In opposition, with a clinical ROI, the 1 cm-thick bolus was largely underestimated with an average displacement value of 0.28 cm only. To limit the impact of patient breathing on surface deformation, dynamic surface captures and the use of the corrected patient position should be privileged. Using AlignRT, a clinical workflow for breast swelling follow-up was developed to help in the decision for repeat simulation and dosimetry. Conclusion The surface deformation module provides an accurate, simple, and radiation-free approach to detect and quantify breast oedema during the course of radiotherapy.

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Section: Resultsmentioning

confidence: 99%

“…Indeed, weight loss/gain, changes in breast size and shape, oedema, seroma, etc. [7] , [8] have shown to yield under or over-dosage especially with the most recent delivery techniques [8] , [9] , [10] .…”

Section: Introductionmentioning

confidence: 99%

Benchmarking the AlignRT surface deformation module for the early detection and quantification of oedema in breast cancer radiotherapy

Sorgato¹,

Ghazouani

Queffelec

et al. 2022

Technical Innovations & Patient Support in Radiation Oncolo

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“… 29 A systematic review and meta-analysis of side effects associated with the use of IMRT in adjuvant BC treatment can be found elsewhere. 30 …”

Section: Resultsmentioning

confidence: 99%

Breast size impact on adjuvant radiotherapy adverse effects and dose parameters in treatment planning

Ratoša

Jenko

Oblak

2018

Radiology and Oncology

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BackgroundBreast radiotherapy is an established adjuvant treatment after breast conserving surgery. One of the important individual factors affecting the final cosmetic outcome after radiation is breast size. The purpose of this review is to summarise the clinical toxicity profile of adjuvant radiotherapy in women with breasts of various sizes, and to evaluate the treatment planning studies comparing target coverage and dose to thoracic organs at risk in relation to breast size.ConclusionsInhomogeneity and excessive radiation dose (hot spots) in the planning of target volume as well as large volume of the breast per se, all contribute to a higher rate of acute adverse events and suboptimal final cosmetic outcome in adjuvant breast cancer radiotherapy, regardless of the fractionation schedule. Improved homogeneity leads to a lower rate of ≥ grade 2 toxicity and can be achieved with three-dimensional conformal or modulated radiotherapy techniques. There may be an association between body habitus (higher body mass index, bigger breast size, pendulous breast, and large chest wall separation) and a higher mean dose to the ipsilateral lung and whole heart. A combination of the technical innovations (i.e. the breath-hold technique, prone position with or without holding breath, lateral decubitus position, and thermoplastic bra), dose prescription (i.e. moderate hypofractionation), and irradiated volume (i.e. partial breast irradiation) should be tailored to every single patient in clinical practice to mitigate the risk of radiation adverse effects.

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“…Sin embargo, en algunas localizaciones, como es el caso de la irradiación de mama con cadenas ganglionares axilo supraclaviculares ipsilaterales (niveles ganglionares I-IV) sin inclusión de la cadena ganglionar mamaria interna, no existe un consenso entre la comunidad científica sobre la idoneidad de este tipo de tratamientos frente a la radioterapia conformada tridimensional (3D Dimensional Conformal Radiotherapy, 3DCRT). [1][2][3][4][5] La IMRT, mediante la diversificación de las entradas de los haces, ya sea con múltiples incidencias o mediante arcos en IMRT volumétrica (Volumetric Intensity ModulatedArcTherapy, VMAT), permite conformar las dosis medias y altas (valores entre 25-85% y superiores al 85% de la de prescripción respectivamente) en las inmediaciones de los volúmenes objetivo, reduciéndose dicha dosis en los órganos circundantes y limitando así la aparición de gran parte de los efectos deterministas que causa la radiación sobre los tejidos sanos. Concretamente en la irradiación de mama las toxicidades más comunes se producen por la irradiación con dosis altas de la piel (eritemas, descamación de la piel, hiperpigmentación y telangiectasia) 6,7 y con dosis medias-altas de los pulmones 8,9 (neumonitis o fibrosis pulmonar).…”

Section: Introductionunclassified

Análisis de los riesgos asociados al uso de la técnica VMAT frente a 3DCRT en tratamientos de mama con cadenas ganglionares axilo-claviculares

et al. 2021

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La utilización de arcoterapia volumétrica de intensidad modulada (VMAT) para el tratamiento de cáncer de mama siempre ha sido un asunto controvertido. La mayor conformación de las dosis absorbidas altas que se consigue con la VMAT frente a la radioterapia conformada (3DCRT) viene acompañada de un incremento del volumen irradiado con dosis absorbidas bajas, cuyas consecuencias hay que analizar. El presente estudio pretende, mediante el análisis de las dosimetrías clínicas de 80 pacientes con cáncer de mama tratadas en nuestro centro con ambas técnicas, evaluar la idoneidad de la elección de una técnica frente a la otra para el tratamiento de pacientes con cáncer de mama que precisan la irradiación de cadenas ganglionares axilo-claviculares, pero no de la cadena mamaria interna. Para ello se tienen en cuenta por un lado criterios puramente dosimétricos, como el cumplimiento de los límites de dosis absorbida establecidos en órganos de riesgo, y por otro se realiza una estimación del aumento en la probabilidad de desarrollar tumores secundarios sólidos por la irradiación a baja dosis de órganos sanos y se evalúan las posibles la toxicidades, cardiacas y pulmonares, en base a lo descrito en la literatura.

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Side Effects Associated with the Use of Intensity-Modulated Radiation Therapy in Breast Cancer Patients Undergoing Adjuvant Radiation Therapy: A Systematic Review and Meta-Analysis

Cited by 8 publications

References 31 publications

Benchmarking the AlignRT surface deformation module for the early detection and quantification of oedema in breast cancer radiotherapy

Benchmarking the AlignRT surface deformation module for the early detection and quantification of oedema in breast cancer radiotherapy

Breast size impact on adjuvant radiotherapy adverse effects and dose parameters in treatment planning

Análisis de los riesgos asociados al uso de la técnica VMAT frente a 3DCRT en tratamientos de mama con cadenas ganglionares axilo-claviculares

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