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Adaptive radiation therapy for breast IMRT-simultaneously integrated boost: three-year clinical experience
Coen W Hurkmans1, Ingrid Dijckmans, Miranda Reijnen
1Department of Radiation Oncology, Catharina Hospital, Eindhoven, The Netherlands. coen.hurkmans@cze.nl
Summary
Adaptive radiation therapy (ART) effectively manages seroma volume reduction during breast cancer radiotherapy. This strategy ensures accurate treatment delivery with intensity-modulated radiation therapy with simultaneously integrated boost (IMRT-SIB), preventing treatment delays.
Area of Science:
- Radiation Oncology
- Medical Physics
Background:
- Seroma volume reduction is a common occurrence during breast-conserving radiotherapy.
- This reduction can potentially compromise the accuracy of radiation delivery in intensity-modulated radiation therapy with simultaneously integrated boost (IMRT-SIB).
Purpose of the Study:
- To evaluate the efficacy of an adaptive radiation therapy (ART) strategy involving rescanning and replanning to account for seroma volume reduction during IMRT-SIB for breast cancer patients.
Main Methods:
- A cohort of 1274 patients undergoing IMRT-SIB was analyzed.
- Patients with initial seroma volume >30 cm³ and less than 30 days between planning CT and lumpectomy were rescanned and replanned if significant changes were observed.
Main Results:
- Nine percent of patients met the criteria for rescanning, with 77% of their treatment plans being adapted.
- Adapted plans showed significant reductions in seroma volume (60 to 27 cm³), total breast volume (70 to 45 cm³), and planning target volume for the boost (277 to 220 cm³).
- The high-dose volume (V95% of total dose) was reduced by 19%, preventing treatment delays.
Conclusions:
- The adaptive radiation therapy IMRT-SIB procedure is efficient and effective in managing seroma-related volume changes.
- This approach allows for the continued use of highly conformal IMRT-SIB techniques even in the presence of seroma, ensuring accurate and timely breast cancer treatment.
