Postmastectomy intensity modulated radiation therapy following immediate expander-implant reconstruction Journal Article
| Authors: | Koutcher, L.; Ballangrud, A.; Cordeiro, P. G.; McCormick, B.; Hunt, M.; Zee, K. J. V.; Hudis, C.; Beal, K. |
| Article Title: | Postmastectomy intensity modulated radiation therapy following immediate expander-implant reconstruction |
| Abstract: | Background/purpose: To evaluate radiation plans of patients undergoing mastectomy with immediate expander-implant reconstruction followed by postmastectomy radiation therapy (PMRT). Materials/methods: We identified 41 patients from June 2004 to May 2007 who underwent mastectomy, immediate expander-implant reconstruction, and PMRT with intensity-modulated radiation therapy. We assessed chest wall (CW) coverage and volume of heart and lung irradiated. Results: In 73% of patients, all CW borders were adequately covered, and in 22%, all but 1 border were adequately covered. The total lung V20 was <20% in 39/41 patients. The mean lung V20 was 13% (range, 3-23%), and the mean heart Dmean was 2.81 Gy (range, 0.53-9.60 Gy). In patients with left-sided lesions without internal mammary nodes (IMNs) treatment (n = 22), the mean lung V20 was 12.6% and the mean heart Dmean was 3.90 Gy, and in the patient with IMN treatment, the lung V20 was 18% and heart Dmean was 8.04 Gy. For right-sided lesions without IMN treatment (n = 12), the mean lung V20 was 12.4% and the mean heart Dmean was 0.90 Gy, and in patients with IMN treatment (n = 6), these numbers were 17.8% and 1.76 Gy. At a median follow-up of 29 months, the 30-month actuarial local control was 97%. Conclusions: In women undergoing immediate expander-implant reconstruction, PMRT can achieve excellent local control with acceptable heart and lung doses. These results can be achieved even when the IMN are being treated, although doses to the heart and lungs will be higher. © 2009 Elsevier Ireland Ltd. All rights reserved. |
| Keywords: | adult; clinical article; controlled study; aged; middle aged; reconstructive surgical procedures; retrospective studies; young adult; intensity modulated radiation therapy; treatment planning; radiation dose; mastectomy; radiotherapy dosage; breast neoplasms; time factors; breast implants; heart dmean; immediate reconstruction; lung v20; postmastectomy radiation; heart volume; lung volume |
| Journal Title: | Radiotherapy and Oncology |
| Volume: | 94 |
| Issue: | 3 |
| ISSN: | 0167-8140 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2010-03-01 |
| Start Page: | 319 |
| End Page: | 323 |
| Language: | English |
| DOI: | 10.1016/j.radonc.2009.12.003 |
| PUBMED: | 20096946 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 2" - "Export Date: 20 April 2011" - "CODEN: RAOND" - "Source: Scopus" |
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