Skin and lung toxicity in synchronous bilateral breast cancer treated with volumetric-modulated arc radiotherapy: a mono-institutional experience

• M. Valli ^[1] ; S. Cima ^[1] ; D. Gaudino ^[2] ; R. Cartolari ^[3] ; L. Deantonio ^[1] ; M. Frapolli ^[1] ; D. Daniele ^[1] ; G. A. Pesce ^[1] ; F. Martucci ^[1] ; N. C. Azinwi ^[1] ; D. Bosetti ^[1] ; S. Presilla ^[2] ; A. Richetti ^[1]
  1. [1] Istituto Oncologico della Svizzera Italiana

     Istituto Oncologico della Svizzera Italiana

     Bellinzona, Suiza

     
  2. [2] Medical Physics Service, Ente Ospedaliero Cantonale. Bellinzona, Switzerland
  3. [3] Radiology Service, Ente Ospedaliero Cantonale. Bellinzona, Switzerland

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 21, Nº. 11, 2019, págs. 1492-1498
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Purpose To evaluate acute and late skin/subcutaneous toxicities and radiation-induced lung fibrosis (RILF) in patients treated with adjuvant radiotherapy (RT) for synchronous bilateral breast cancers (SBBC), after conservative surgery.

    Methods/patients Twenty-five patients were treated with volumetric-modulated arc therapy (VMAT/RapidArc®) on both breasts, and checked clinically for detecting RT toxicities during and after treatment. A high-resolution computed tomography (HRCT) was performed, for detecting RILF during follow-up.

    Results We registered acute Grade-1 skin toxicity in 18 patients (72%), while six patients (24%) experienced Grade-2 toxicity. No breath symptoms were reported during and after RT. Late Grade-1 subcutaneous toxicity and late Grade-2 skin toxicity were registered in four patients (16%) and one patient (4%), respectively, at a mean follow-up of 36 months. Grade-1 RILF was detected in six patients (30%). The median volume of fibrosis area was 6.5 cc (range 1.3–21.5 cc). The partial volumes receiving a specified dose (V20, V30, V40, and V50) in patients who developed lung fibrosis were significantly bigger than who did not (p < 0.01). We showed that the mean volume of the tumour boost of patients who developed fibrosis (77.7 cc) was not significantly different from the other patients (90.8 cc) (p = 0.5).

    Conclusion The clinical impact of this technique is favourable, and this is the first clinical study showing RILF by HRCT in a setting of SBBC. Further study with larger accrual is mandatory.