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  • [Front Oncol.] Hypofractionated Radiotherapy Dose Scheme and Application of New Techniques Are Associated to a Lower Incidence of Radiation Pneumonitis in Breast Cancer Patients.소분할방사선치료 및 새로운기술 적용과 유방암환자의 방사선폐렴 발생 감소

    연세의대 / 이병민, 김용배*

  • 출처
    Front Oncol.
  • 등재일
    2020 Feb 11
  • 저널이슈번호
    10:124. doi: 10.3389/fonc.2020.00124. eCollection 2020.
  • 내용

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    Abstract
    Purpose: Radiation pneumonitis (RP) is one of the most severe toxicities experienced by patients with breast cancer after radiotherapy (RT). RT fractionation schemes and techniques for breast cancer have undergone numerous changes over the past decades. This study aimed to investigate the incidence of RP as a function of such changes in patients with breast cancer undergoing RT and to identify dosimetric markers that predict the risk of this adverse event. Methods and Materials: We identified 1,847 women with breast cancer who received adjuvant RT at our institution between 2015 and 2017. The RT technique was individually tailored based on each patient's clinicopathological features. Deep inspiration breath hold technique or prone positioning were used for patients who underwent left whole-breast irradiation for cardiac sparing, while those requiring regional lymph node irradiation underwent volumetric-modulated arc therapy (VMAT). Results: Of 1,847 patients who received RT, 21.2% received the conventional dose scheme, while 78.8% received the hypofractionated dose scheme (mostly 40 Gy in 15 fractions). The median follow-up period was 14.5 months, and the overall RP rate was 2.1%. The irradiated organ at risk was corrected concerning biologically equivalent dose. The ipsilateral lung V30 in equivalent dose in 2 Gy (EQD2) was the most significant dosimetric factor associated with RP development. Administering RT using VMAT, and hypofractionated dose scheme significantly reduced ipsilateral lung V30. Conclusions: Application of new RT techniques and hypofractionated scheme significantly reduce the ipsilateral lung dose. Our data demonstrated that ipsilateral lung V30 in EQD2 is the most relevant dosimetric predictor of RP in patients with breast cancer.

     

     


    Author information

    Lee BM1, Chang JS1, Kim SY1, Keum KC1, Suh CO2, Kim YB1.
    1
    Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea.
    2
    Department of Radiation Oncology, CHA Bundang Medical Center, CHA University, Bundang-gu, South Korea.

  • 키워드
    breast cancer; hypofractionation; lung dosimetry; radiation pneumonitis; radiotherapy
  • 편집위원

    대규모 환자군을 대상으로 유방암에 대한 방사선치료 기술 및 분할조사 방법이 방사선폐렴에 미치는 영향을 분석한 논문

    2020-04-01 16:05:37

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