KEY TAKEAWAYS
- The study aimed to assess implant-sparing irradiation versus conventional RT methods in breast cancer patients with immediate breast reconstruction.
- The study concluded that conventional H and TD plans outperformed implant-sparing helical plans dosimetrically, necessitating long-term clinical outcomes.
Cem Onal and the team aimed to evaluate implant-sparing irradiation versus conventional RT (H and TD) in patients with breast cancer undergoing immediate breast reconstruction.
The study analyzed the dosimetric parameters of 40 patients with retropectoral implants receiving 50.4 Gy in 28 fractions. The 3 devised plans were the H plan, including the chest wall, skin, and implant in the conventional planning target volume (PTV); the TD plan using the conventional PTV; and the Hs plan employing an implant-sparing PTV. Comparisons were made among the H, TD, and Hs plans regarding PTV doses, organ-at-risk (OAR) doses, and treatment times.
The results revealed that in the Hs plan, dose distribution was less homogeneous and uniform compared to the H and TD plans. The TD plan exhibited lower doses to the lung, heart, contralateral breast, spinal cord, liver, and esophagus than the Hs plan. Relative to the Hs plan, the H plan showed a higher lung volume receiving 5 Gy (V5) (39.1±3.9 vs. 41.2±3.9 Gy; P<0.001), increased V20 (12.3±1.3 vs. 11.5±2.6 Gy; P=0.02), and elevated V30 (7.5±1.6 vs. 4.4±1.7 Gy; P<0.001).
The H plan outperformed the Hs plan in heart dosimetric parameters, except for V20. Additionally, the Hs plan exhibited significantly lower mean implant doses (43.4±2.1 Gy) than the H plan (51.4±0.5 Gy; P<0.001) and the TD plan (51.9±0.6 Gy; P<0.001). Implementing an implant-sparing technique for silicone dose reduction resulted in decreased lung doses.
The study concluded that conventional H and TD plans demonstrate superior dosimetric performance compared to the implant-sparing helical plan. However, the unpredictability of capsular contracture during radiation therapy necessitates long-term clinical follow-up to ascertain whether sparing silicon should be prioritized.
No funding was provided.
Source: https://pubmed.ncbi.nlm.nih.gov/38688603/
Onal C, Bozca R, Dolek Y, et al. (2024). “A Comparative Analysis of Implant-sparing Plan Versus Conventional Plans Utilizing Helical Tomotherapy in Breast Cancer Patients Undergoing Breast Reconstruction.” In Vivo. 2024 May-Jun;38(3):1412-1420. doi: 10.21873/invivo.13583. PMID: 38688603.
