Ultra-Hypofractionated Whole Breast Radiotherapy with Automated Hybrid-VMAT Technique: A Pilot Study on Safety, Skin Toxicity and Aesthetic Outcomes.

IF 3.3 4区 医学 Q2 ONCOLOGY Breast Cancer : Targets and Therapy Pub Date : 2024-09-16 eCollection Date: 2024-01-01 DOI:10.2147/BCTT.S470417
Mariangela Boccardi, Savino Cilla, Mara Fanelli, Carmela Romano, Paolo Bonome, Milena Ferro, Donato Pezzulla, Roberto Di Marco, Francesco Deodato, Gabriella Macchia
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Abstract

Purpose: The most prevalent treatment-related side effect related to adjuvant radiotherapy (RT) for breast cancer is acute skin toxicity in the irradiated area. The purpose of this single-institution pilot study is to provide preliminary clinical results on the feasibility and safety of a breast ultra-hypofractionated radiation treatment delivered using an automated hybrid-VMAT technique. Skin damage was assessed both with clinical examination and objectively using a Cutometer equipment.

Patients and methods: Patients received 26 Gy to the whole breast and 30 Gy to the tumoral bed in 5 fractions using an automated hybrid-VMAT approach with the option for the breath hold technique if necessary. Acute and late toxicities were clinically evaluated at baseline, 1- and 6-months after treatment using the CTC-AE v.5.0 scale. An instrumental evaluation of the skin elasticity was performed using a Cutometer® Dual MP580. Two parameters per patient, R0 (the total skin firmness) and Q1 (the elastic recovery), were registered at the different timelines.

Results: From June 2022 to January 2024, 30 patients, stage T1-T2, N0 were enrolled in the study. Four out of 30 (13.3%) patients reported G2 acute skin toxicities. At 6 months, G2 late toxicity was registered in 3 patients (10%). A total of 2160 measures of R0 and Q1 were recorded. At 1 month after treatment, no correlation was found between measured values of R0 and Q1 and clinical evaluation. At 6 months after treatment, clinical late toxicity ≥1 was strongly associated with decreased R0 and Q1 values ≥24% (p = 0.003) and ≥18% (p = 0.022), respectively.

Conclusion: Ultra-hypofractionated whole-breast radiotherapy, when supported by advanced treatment techniques, is both feasible and safe. No severe adverse effects were observed at any of the different timeframes. Acute and late skin toxicities were shown to be lower in contrast to data presented in the literature.

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采用自动混合 VMAT 技术的超高分次全乳腺放疗:关于安全性、皮肤毒性和美学效果的试点研究
目的:乳腺癌辅助放射治疗(RT)最常见的治疗相关副作用是照射区域的急性皮肤毒性。这项单机构试点研究的目的是提供初步临床结果,说明使用自动混合 VMAT 技术进行乳腺超高分次放射治疗的可行性和安全性。皮肤损伤通过临床检查和Cutometer设备进行客观评估:患者接受全乳腺 26 Gy 放射治疗,肿瘤床 30 Gy 放射治疗,分 5 次进行,采用自动混合 VMAT 方法,必要时可选择屏气技术。使用 CTC-AE v.5.0 量表对基线、治疗后 1 个月和 6 个月的急性和晚期毒性进行临床评估。使用 Cutometer® Dual MP580 对皮肤弹性进行了仪器评估。每位患者在不同时间段的两个参数,即 R0(皮肤总体紧致度)和 Q1(弹性恢复),都进行了登记:结果:从 2022 年 6 月到 2024 年 1 月,共有 30 名 T1-T2 期 N0 患者参与了研究。30 名患者中有 4 名(13.3%)报告了 G2 急性皮肤毒性。6个月后,3名患者(10%)出现G2晚期毒性。共记录了 2160 次 R0 和 Q1 测量。治疗后 1 个月时,R0 和 Q1 的测量值与临床评估之间没有相关性。治疗后6个月,临床晚期毒性≥1与R0和Q1值的下降密切相关,分别为≥24%(P = 0.003)和≥18%(P = 0.022):结论:在先进治疗技术的支持下,超高分次全乳腺放疗既可行又安全。在不同时间段均未观察到严重的不良反应。与文献数据相比,急性和晚期皮肤毒性较低。
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来源期刊
CiteScore
4.10
自引率
0.00%
发文量
40
审稿时长
16 weeks
期刊最新文献
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