Evaluation of apical clips placed during axillary dissection demonstrates potential under‐coverage of axillary radiation therapy target volumes during breast cancer regional nodal irradiation

2021 ◽  
Author(s):  
Michael Ti Hsieh ◽  
Noel J Aherne ◽  
William Ross ◽  
Shehnarz Salindera ◽  
Justin Westhuyzen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Axillary Dissection ◽  
Regional Nodal Irradiation ◽  
Target Volumes ◽  
Therapy Target

scholarly journals Analysis of Radiation Dose to the Shoulder by Treatment Technique and Correlation With Patient Reported Outcomes in Patients Receiving Regional Nodal Irradiation

2021 ◽  
Vol 11 ◽  
Author(s):  
Jose G. Bazan ◽  
Dominic DiCostanzo ◽  
Karen Hock ◽  
Sachin Jhawar ◽  
Karla Kuhn ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Radiation Dose ◽  
Patient Reported Outcomes ◽  
Late Complication ◽  
Treatment Technique ◽  
Regional Nodal Irradiation ◽  
Patient Reported ◽  
The Impact ◽  
Dash Questionnaire

Background/PurposeShoulder/arm morbidity is a late complication of breast cancer treatment with surgery and regional nodal irradiation (RNI). We set to analyze the impact of radiation technique [intensity modulated radiation therapy (IMRT) or 3D conformal radiation therapy (3DCRT)] on radiation dose to the shoulder with a hypothesis that IMRT use results in smaller volume of shoulder receiving radiation. We explored the relationship of treatment technique on long-term patient-reported outcomes using the quick disabilities of the arm, shoulder, and hand (q-DASH) questionnaire.Materials/MethodsWe identified patients treated with adjuvant RNI (50 Gy/25 fractions) from 2013 to 2018. We retrospectively contoured the shoulder organ-at-risk (OAR) from 2 cm above the ipsilateral supraclavicular (SCL) planning target volume (PTV) to the inferior SCL PTV slice and calculated the absolute volume of shoulder OAR receiving 5–50 Gy (V5–V50). We identified patients that completed a q-DASH questionnaire ≥6 months from the end of RNI.ResultsWe included 410 RNI patients: 54% stage III, 72% mastectomy, 35% treated with IMRT. IMRT resulted in significant reductions in the shoulder OAR volume receiving 20–50 Gy vs. 3DCRT. In total, 82 patients completed the q-DASH. The mean (SD) q-DASH=25.4 (19.1) and tended to be lower with IMRT vs. 3DCRT: 19.6 (16.4) vs. 27.8 (19.8), p=0.078.ConclusionWe found that IMRT reduces radiation dose to the shoulder and is associated with a trend toward reduced q-DASH scores ≥6 months post-RNI in a subset of our cohort. These results support prospective evaluation of IMRT as a technique to reduce shoulder morbidity in breast cancer patients receiving RNI.

Delineation of Internal Mammary Nodal Target Volumes in Breast Cancer Radiation Therapy

2017 ◽  
Vol 97 (4) ◽  
pp. 762-769 ◽  
Author(s):  
Krishan R. Jethwa ◽  
Mohamed M. Kahila ◽  
Katie N. Hunt ◽  
Lindsay C. Brown ◽  
Kimberly S. Corbin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Target Volumes ◽  
Internal Mammary

Delineation of Supraclavicular Target Volumes in Breast Cancer Radiation Therapy

2015 ◽  
Vol 92 (3) ◽  
pp. 642-649 ◽  
Author(s):  
Lindsay C. Brown ◽  
Felix E. Diehn ◽  
Judy C. Boughey ◽  
Stephanie K. Childs ◽  
Sean S. Park ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Target Volumes

scholarly journals Long Term Arm and Shoulder Toxicities in Breast Cancer Patients Receiving Hypofractionated Radiation Therapy

2021 ◽  
Vol 6 (3) ◽  
pp. 311-315
Author(s):  
Prateek Daga ◽  
Harvinder Singh Kumar ◽  
Neeti Sharma ◽  
Shankar Lal Jakhar ◽  
Kamlesh Kumar Harsh
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Regional Nodal Irradiation ◽  
Therapy Assessment ◽  
Conventional Radiation ◽  
Hypofractionated Radiation ◽  
Fraction Dose

   Aim: The purpose of this study is to evaluate the late toxicities in hypo fractionated radiation schedule in breast cancer patients with regional nodal irradiation (RNI), limited to axilla and supraclavicular regions. Late effects on arm and shoulder were noted as follows: skin edema (lymphedema), restricted shoulder movements (brachial plexus injury) and localised pain.Material and Methods: In this study we randomly enrolled 100 breast cancer post mastectomy cases in the year 2018. All cases were previously asymptomatic after surgery. They were prospectively treated with hypo fractionated local and regional nodal irradiation by 2.67 gray / fraction dose, total 15 fractions (total dose-40 gray). Evaluation was done at 12 months after completion of radiation therapy. Assessment was done by RTOG, LENT- SOMA scales. Results: Significant lymphedema was observed in 17 (17%) cases. Restricted arm mobility was seen in 14 (14%) of patients. Pain (moderate/severe) in arm and shoulder was most commonly seen, in 25 (25%) cases. Conclusions: As hypo fractionated regimes in breast cancer treatment have become new standard; its late term effects are significant and comparable to other conventional radiation therapy regimes. These studies need further and longer duration of evaluation.    

Sign in / Sign up

Export Citation Format

Share Document