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. 2023 Aug 28;28(4):478-484.
doi: 10.5603/RPOR.a2023.0053. eCollection 2023.

Beyond the heart in hypofractionated radiotherapy and in the transition from 3D to IMRT/VMAT

Lorena Lio Mondragon  1 , Hidralba Pérez Lopez  1 , Adolfo Fernández Diaz  1 , Iván Avilés Lio  1 , Alejandro Olmos Guzman  2
Affiliations

Beyond the heart in hypofractionated radiotherapy and in the transition from 3D to IMRT/VMAT

Lorena Lio Mondragon et al. Rep Pract Oncol Radiother. .

Abstract

Background: The knowledge of the risks induced by radiation with hypofractionation regimens has only recently been estimated together with its implementation as a management standard. However, the dose to other risk organs with intensity-modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT) is not clear, that is why this is only a reference study of radiation doses to organs at risk in hypofractionation in our center.

Materials and methods: We completed a retrospective and observational analysis of 1398 patients treated with adjuvant hypofractionated radiotherapy from 2015 to 2018, using the clinical records and dose-volume histogram of patients treated with moderate hypofractionated adjuvant radiotherapy. To analyze the institutional experience on the dosimetry of the esophagus and liver as risk organs in the use of moderate adjuvant hypofractionated radiotherapy in breast cancer.

Results: The dosimetry of the esophagus was 3271 cGy DMax, 177 cGy DMed, 68 cGy D50%, 500 cGy DcMAX with 3D RT and 4124 cGy DMax, 1242 cGy DMed, 934.50 cGy D50%, 3213 cGy DcMAX with IMRT/VMAT and the dosimetry for the liver was for right breast cancer 466 cGy DMed, 102 cGy D50% and 8% V20, for left breast cancer 22 cGy DMed, 6.10 cGy D50% and 0.3% V20.

Conclusion: The statistically significant differences in irradiation show the lack of consensus on the optimal restrictions in hypofractionation regimens to reduce clinical sequela; consequently, the variability in the specification of each radiation oncologist is observed; standardization in our center can lead to improvement in the quality of treatments.

Keywords: breast cancer; esophagus; liver.

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Conflict of interest statement

Conflict of interest None declared.

References

    1. Clark RM, Whelan T, Levine M, et al. Randomized clinical trial of breast irradiation following lumpectomy and axillary dissection for node-negative breast cancer: an update. Ontario Clinical Oncology Group. J Natl Cancer Inst. 1996;88(22):1659–1664. doi: 10.1093/jnci/88.22.1659. - DOI - PubMed
    1. Wenz F, Budach W. Personalized radiotherapy for invasive breast cancer in 2017 : National S3 guidelines and DEGRO and AGO recommendations. Strahlenther Onkol. 2017;193(8):601–603. doi: 10.1007/s00066-017-1158-1. - DOI - PubMed
    1. Peng G, Wang T, Yang KY, et al. A prospective, randomized study comparing outcomes and toxicities of intensity-modulated radiotherapy vs. conventional two-dimensional radiotherapy for the treatment of nasopharyngeal carcinoma. Radiother Oncol. 2012;104(3):286–293. doi: 10.1016/j.radonc.2012.08.013. - DOI - PubMed
    1. Sujenthiran A, Nossiter J, Parry M, et al. Treatment-related toxicity in men who received Intensity-modulated versus 3D-conformal radiotherapy after radical prostatectomy: A national population-based study. Radiother Oncol. 2018;128(2):357–363. doi: 10.1016/j.radonc.2018.04.032. - DOI - PubMed
    1. Habl G, Katayama S, Uhl M, et al. Helical intensity-modulated radiotherapy of the pelvic lymph nodes with a simultaneous integrated boost to the prostate--first results of the PLATIN 1 trial. BMC Cancer. 2015;15:868. doi: 10.1186/s12885-015-1886-5. - DOI - PMC - PubMed

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