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Published on: February 6, 2019
Three-dimensional conformal simultaneously integrated boost technique for breast-conserving radiotherapy
Hans Paul van der Laan1, Wil V Dolsma, John H Maduro
1Department of Radiation Oncology, University Medical Center Groningen/University of Groningen, 9700 RB Groningen, The Netherlands. h.p.van.der.laan@rt.umcg.nl
Summary
The simultaneously integrated boost (SIB) technique offers improved dose distribution and reduced irradiated volumes in breast cancer radiotherapy compared to sequential boost. This method also shows a low incidence of acute skin toxicity.
Area of Science:
- Radiation Oncology
- Medical Physics
- Oncology
Background:
- Breast-conserving surgery followed by radiotherapy is standard for early-stage breast cancer.
- Boost radiotherapy aims to improve local control by delivering a higher dose to the tumor bed.
- Simultaneously integrated boost (SIB) and sequential boost are two techniques for delivering boost radiation.
Purpose of the Study:
- To compare target coverage and normal tissue dose between SIB and sequential boost techniques.
- To evaluate acute skin toxicity in patients treated with SIB for breast cancer.
Main Methods:
- Thirty early-stage breast cancer patients received SIB radiotherapy.
- Dose-volume histograms were compared between SIB and sequential boost techniques.
- Acute skin toxicity was assessed in 90 patients using Common Terminology Criteria for Adverse Events v3.0.
Main Results:
- SIB demonstrated adequate PTV coverage with more efficient boost beam shaping.
- SIB reduced the mean volume receiving >107% of breast dose by 20% and >95% of boost dose by 54%.
- Mean heart and lung doses were reduced by 10% with SIB; 32.2% of patients experienced Grade 2 or worse acute skin toxicity.
Conclusions:
- SIB is recommended for standard use in breast-conserving radiotherapy.
- Advantages include dose-limiting capabilities, ease of implementation, fewer fractions, and acceptable toxicity.
- SIB offers a favorable balance of efficacy and toxicity for breast cancer patients.
