Minimizing a tricky situation in breast irradiation with helical tomotherapy

Area of Science:

• Oncology
• Radiation Oncology
• Medical Physics

Background:

• Adjuvant radiotherapy is standard for breast cancer, often using intensity-modulated techniques.
• TomoDirect (static angle helical tomotherapy) is an advanced radiotherapy delivery method.
• Patient injury during treatment can necessitate treatment adaptation.

Observation:

• A breast cancer patient undergoing adjuvant intensity-modulated whole breast and lymph node irradiation with TomoDirect sustained a traumatic ipsilateral humeral fracture.
• The fracture posed a challenge to continuing the planned radiotherapy course.

Findings:

• Radiotherapy was successfully continued using helical tomotherapy, a different mode of the same machine.
• Daily dosimetric monitoring with the Planned Adaptive module enabled precise dose delivery.
• Treatment adaptation ensured the patient received the prescribed radiation dose without compromising safety.

Implications:

• This case demonstrates the feasibility of adapting radiotherapy treatment plans in response to unexpected patient events.
• Helical tomotherapy and adaptive planning offer flexibility in managing complex patient scenarios during radiation therapy.
• The findings support the use of advanced radiotherapy techniques for managing treatment interruptions due to patient injury.