Postmastectomy CT-based electron beam radiotherapy: Dosimetry, efficacy, and toxicity in 118 patients Journal Article
| Authors: | Spierer, M.; Hong, L. X.; Wagman, R. T.; Katz, M. S.; Spierer, R. L.; McCormick, B. |
| Article Title: | Postmastectomy CT-based electron beam radiotherapy: Dosimetry, efficacy, and toxicity in 118 patients |
| Abstract: | Purpose: To evaluate the technique, dosimetry, acute and late toxicity, local control (LC), and overall survival (OS) with the use of computed tomography (CT)-based postmastectomy electron beam therapy (PMEBT) in high-risk patients. Methods and materials: From 1990 to 2000, 118 patients with pathologic stage I-IIIB breast cancer underwent PMEBT of the chest wall (CW) (n = 3), CW and supraclavicular fossa (SCV) (n = 63), CW, SCV, and internal mammary lymph nodes (IMN) (n = 51), and SCV+IMN (n = 1). Radiation therapy was delivered with an en face electron beam with a custom cutout. Treatment plans were all CT-based. The plans of 16 patients were retrospectively reviewed to analyze dosimetry data. A retrospective chart review was conducted to assess acute and late complications, LC, and OS. Results: At a median follow-up of 43 months, 5-year LC and OS were 91% and 61%, respectively. Sixty-one patients developed acute grade 3-4 skin toxicity, necessitating treatment breaks in 33 patients. Fifteen patients experienced a worsening of lymphedema, and 2 patients developed cardiac injury thought to be unrelated to radiotherapy. No patients developed symptomatic pneumonitis. Dosimetric analysis revealed heart and lung normal tissue complication probabilities of zero. Analysis of other clinically relevant dosimetric parameters revealed PMEBT to be comparable to previously reported techniques. Conclusion: Postmastectomy electron beam therapy is an effective way to deliver radiation to the postmastectomy chest wall and adjacent nodal sites. It offers acceptable acute and late toxicities and a high degree of local control given the high-risk population to which it is offered. © 2004 Elsevier Inc. |
| Keywords: | adult; cancer survival; aged; middle aged; survival analysis; major clinical study; review; skin toxicity; cancer radiotherapy; radiation dose; combined modality therapy; cancer staging; follow up; computer assisted tomography; breast cancer; mastectomy; radiotherapy dosage; radiotherapy; tomography, x-ray computed; patient monitoring; breast neoplasms; retrospective study; risk assessment; pneumonia; lymphedema; skin; computerized tomography; dosimetry; lymph node; radiation injuries; toxicity; time series analysis; electrons; thorax wall; heart injury; treatment plans; parameter estimation; electron beam; lymphatic irradiation; postmastectomy radiotherapy; electron beams; humans; human; female; priority journal; radiotherapy techniques; electron beam radiotherapy; local control (lc); overall survival (os) |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 60 |
| Issue: | 4 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2004-11-15 |
| Start Page: | 1182 |
| End Page: | 1189 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2004.04.044 |
| PROVIDER: | scopus |
| PUBMED: | 15519790 |
| DOI/URL: | |
| Notes: | Int. J. Radiat. Oncol. Biol. Phys. -- Cited By (since 1996):10 -- Export Date: 16 June 2014 -- CODEN: IOBPD -- Source: Scopus |
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