Year :
2016
| Month :
July
| Volume :
10
| Issue :
7
| Page :
XC05 - XC08
Full Version
A Study on Dosimetric Outcomes and Acute Toxicity of Post Mastectomy Adjuvant Hypofractionated Radiotherapy for Breast Cancer
Published: July 1, 2016 | DOI: https://doi.org/10.7860/JCDR/2016/.8146
Shivaprasad Deshmukh, Krishna Sharan, Donald Jerard Fernandes, Vidyasagar Mamidipudi Srinivasa, Prahlad Hiremagalur Yathiraj, Anshul Singh, Anusha Reddy
1. Resident, Department of Radiotherapy, Kasturba Medical College, Manipal, Karnataka, India.
2. Associate Professor, Departmentof Radiotherapy, Kasturba Medical College, Manipal, Karnataka, India.
3. Professor and Head, Department of Radiotherapy, Kasturba Medical College, Manipal, Karnataka, India.
4. Professor, Department of Radiotherapy, Kasturba Medical College, Manipal, Karnataka, India.
5. Assistant Professor, Department of Radiotherapy, Kasturba Medical College, Manipal, Karnataka, India.
6. Assistant Professor, Department of Radiotherapy, Kasturba Medical College, Manipal, Karnataka, India.
7. Senior Resident, Department of Radiotherapy, Kasturba Medical College, Manipal, Karnataka, India.
Correspondence Address :
Dr. Krishna Sharan,
Associate Professor, Department of Radiotherapy, Shirdi Saibaba Cancer Hospital,
Manipal, Udupi Dist, Karnataka-576104, India.
E-mail: tk.sharan@gmail.com
Abstract
Introduction: Hypofractionated External Beam Radiotherapy (HFRT) is a relatively new adjuvant Radiotherapy (RT) schedule for breast cancers following breast conservation surgery and less commonly, following mastectomy. Here we report our experience on normal tissue exposure and acute toxicity of HFRT after mastectomy.
Aim: To assess the dosimetric outcomes and acute toxicity profile of adjuvant HFRT following mastectomy for breast cancer.
Materials and Materials: This prospective observational study considered consecutive patients planned for adjuvant HFRT (42.5 Gy in 16 sessions delivered over 3 weeks) to the chest wall with/without regional nodes between October 2014 and June 2015. The dosimetric parameters including dose homogeneity to the target volume and exposure to heart and lung were analyzed. Acute haematological and dermatological toxicity was recorded until upto three months after completion of RT.
Results: Among the 56 patients treated with HFRT, the mean age was 49 years (range: 28-69 years). Pathologically positive nodes and =pT3 primary was observed in 44 (78.6%) and 12 (21.4%) patients, respectively. Majority (87.5%) received prior adjunct chemotherapy. RT to the supraclavicular fossa was delivered for 39 (69.6%) patients. The mean V90 and V95 to the Planning Target Volume (PTV) were 95% (± 3.3%) and 93% (± 4%), respectively. The maximum dose received was on average 47.7 Gy (112%; range: 46.2-48.5 Gy). The mean lung dose was 10.2 Gy (± 3.5 Gy) and V20 was 20.9% (± 6%). The mean V25 to heart was 6.6% (± 4.8%) for left sided and 0% for right sided tumours (p=0.001). Acute skin toxicity peaked at completion of RT and was tolerable (grade 0, I, II and III reactions were 75%, 16% and 1.8%, respectively). No patient had = grade III haematological toxicity, and treatment was not interrupted for any patient.
Conclusion: Adjuvant HFRT could be planned while meeting the dose constraints to normal tissues in all patients and was well tolerated, with mild to moderate acute adverse effects that did not warrant any therapeutic intervention or treatment interruption.
Keywords
Adjuvant radiotherapy, Haematological toxicity, Hypofractionation, Radiation dermatitis, Radiation pneumonitis
DOI: 10.7860/JCDR/2016/20477.8146
Date of Submission: Apr 03, 2016
Date of Peer Review: May 06, 2016
Date of Acceptance: May 24, 2016
Date of Publishing: Jul 01, 2016
Financial OR OTHER COMPETING INTERESTS: None.
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