Feasibility and safety of simultaneous integrated boost in volumetric modulated arc therapy for early breast cancer after breast-conserving surgery
10.3760/cma.j.cn115355-20220328-00188
- VernacularTitle:瘤床同步推量在早期乳腺癌保乳术后大分割容积调强放疗中的可行性及安全性
- Author:
Siming ZHENG
1
;
Bingshuang HU
;
Jiaxiong ZHOU
;
Minying LI
;
Dingbiao GU
;
Zhen LI
;
Jianrong YU
Author Information
1. 中山市人民医院放疗科，中山 528400
- Keywords:
Breast neoplasms;
Breast-conserving surgery;
Simultaneous integrated boost;
Hypofractionated radiotherapy;
Volumetric modulated arc therapy
- From:
Cancer Research and Clinic
2022;34(10):750-754
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the feasibility and adverse reactions of simultaneous integrated boost (SIB) in volumetric modulated arc therapy (VMAT) for early breast cancer after breast-conserving surgery.Methods:A total of 67 patients with early breast cancer after breast-conserving surgery at Zhongshan People's Hospital from September 2019 to May 2021 were enrolled. All patients received VMAT-SIB to the whole breast and tumor bed. The total breast dose and tumor bed dose were 40.5Gy/15 times every 3 weeks and 48 Gy/15 every 3 weeks respectively. The exposure dose of organs at risk and acute adverse reactions of radiotherapy were evaluated.Results:The average doses of planning target volume of the whole brease (PTV WB) and planning target volume of the boost(PTV BOOST) were (42.0±2.1) Gy and (49.9±0.8) Gy, respectively. The V 95% and V 105% of PTV WB and PTV BOOST were (98.8±1.2)% and (31.4±11.3)%, (99.8±0.6)% and (22.9±10.2)%, respectively. The V 5Gy, V 20Gy, V 30Gy and mean dose (D mean) of ipsilateral lung were (52.4±12.0)%, (15.3±4.5)%, (6.7±2.2)% and (11.0±2.4) Gy respectively. The V 18Gy, V 40Gy and D mean of heart were 3.80% (0.48%,9.60%), 0 (0,0.16%) and (6.7±2.1) Gy respectively. At the end of radiotherapy, 19 patients (29%) of all 67 patients had no acute skin toxicity, 41 patients (61%) showed radiation erythema, 5 patients (7%) had radioactive dry peeling and 2 patients (3%) had wet peeling mainly located in the nipple, areola area and breast folds. None of the patients had grade 3-4 acute skin reactions. Breast swelling and breast pain were found respectively in 9 patients (13%) and 7 patients (10%). No local recurrence or distant metastases were observed during the follow-up period. The 2-year disease-free survival rate was 100%. Conclusions:VMAT combined with SIB is feasible in the treatment of early breast cancer. The adverse reactions of radiotherapy are mild and well tolerated.
