Intensity-Modulated Radiotherapy Results in Significant Decrease in Clinical Toxicities Compared With Conventional Wedge-Based Breast Radiotherapy

Journal Article · Wed Aug 01 00:00:00 EDT 2007 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2007.02.044· OSTI ID:20953593

Harsolia, Asif ^[1]; Kestin, Larry ^[1]; Grills, Inga ^[1]; Wallace, Michelle ^[1]; Jolly, Shruti ^[1]; Jones, Cortney ^[1]; Lala, Moinaktar ^[1]; Martinez, Alvaro ^[1]; Schell, Scott ^[2]; Vicini, Frank A ^[1]

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1. Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)
2. Department of Surgery, William Beaumont Hospital, Royal Oak, MI (United States)

Purpose: We have previously demonstrated that intensity-modulated radiotherapy (IMRT) with a static multileaf collimator process results in a more homogenous dose distribution compared with conventional wedge-based whole breast irradiation (WBI). In the present analysis, we reviewed the acute and chronic toxicity of this IMRT approach compared with conventional wedge-based treatment. Methods and Materials: A total of 172 patients with Stage 0-IIB breast cancer were treated with lumpectomy followed by WBI. All patients underwent treatment planning computed tomography and received WBI (median dose, 45 Gy) followed by a boost to 61 Gy. Of the 172 patients, 93 (54%) were treated with IMRT, and the 79 patients (46%) treated with wedge-based RT in a consecutive fashion immediately before this cohort served as the control group. The median follow-up was 4.7 years. Results: A significant reduction in acute Grade 2 or worse dermatitis, edema, and hyperpigmentation was seen with IMRT compared with wedges. A trend was found toward reduced acute Grade 3 or greater dermatitis (6% vs. 1%, p = 0.09) in favor of IMRT. Chronic Grade 2 or worse breast edema was significantly reduced with IMRT compared with conventional wedges. No difference was found in cosmesis scores between the two groups. In patients with larger breasts ({>=}1,600 cm{sup 3}, n = 64), IMRT resulted in reduced acute (Grade 2 or greater) breast edema (0% vs. 36%, p <0.001) and hyperpigmentation (3% vs. 41%, p 0.001) and chronic (Grade 2 or greater) long-term edema (3% vs. 30%, p 0.007). Conclusion: The use of IMRT in the treatment of the whole breast results in a significant decrease in acute dermatitis, edema, and hyperpigmentation and a reduction in the development of chronic breast edema compared with conventional wedge-based RT.

• OSTI ID: 20953593
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 68, Issue 5; Other Information: DOI: 10.1016/j.ijrobp.2007.02.044; PII: S0360-3016(07)00526-3; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
COLLIMATORS
COMPUTERIZED TOMOGRAPHY
DERMATITIS
EDEMA
IRRADIATION
MAMMARY GLANDS
PATIENTS
RADIATION DOSE DISTRIBUTIONS
RADIATION DOSES
RADIOTHERAPY
TOXICITY