Current role of modern radiotherapy techniques in the management of breast cancer

Abstract

Breast cancer is the most common type of malignancy in females. Advances in systemic therapies and radiotherapy (RT) provided long survival rates in breast cancer patients. RT has a major role in the management of breast cancer. During the past 15 years several developments took place in the field of imaging and irradiation techniques, intensity modulated RT, hypofractionation and partial-breast irradiation. Currently, improvements in the RT technology allow us a subsequent decrease in the treatment-related complications such as fibrosis and long-term cardiac toxicity while improving the loco-regional control rates and cosmetic results. Thus, it is crucial that modern radiotherapy techniques should be carried out with maximum care and efficiency. Several randomized trials provided evidence for the feasibility of modern radiotherapy techniques in the management of breast cancer. However, the role of modern radiotherapy techniques in the management of breast cancer will continue to be defined by the mature results of randomized trials. Current review will provide an up-to-date evidence based data on the role of modern radiotherapy techniques in the management of breast cancer.

Keywords: Breast cancer; Hypofractionation; Intensity modulated radiotherapy; Partial breast irradiation; Radiotherapy.

Figure 1

BEV shaped forward-planned intensity modulated radiotherapy (IMRT) (field-in field technique). Open tangential fields (A and C). DRR showing the multileaf collimator segments closing the volumes receiving ≥ 110% of the prescribed dose (B and D).

Figure 2

Treatment fields and dose distribution of inverse-planned intensity modulated radiotherapy: Axial section (A), dose-volume histogram (B), coronal section (C) and sagittal section (D).