PMID- 28224401
OWN - NLM
STAT- MEDLINE
DCOM- 20170620
LR  - 20181113
IS  - 1826-6983 (Electronic)
IS  - 0033-8362 (Linking)
VI  - 122
IP  - 6
DP  - 2017 Jun
TI  - Synchronous bilateral breast cancer irradiation: clinical and dosimetrical issues 
      using volumetric modulated arc therapy and simultaneous integrated boost.
PG  - 464-471
LID - 10.1007/s11547-017-0741-y [doi]
AB  - OBJECTIVES: The aim of the present retrospective analysis was to evaluate 
      dosimetric parameters, feasibility and outcome for Synchronous Bilateral Breast 
      Cancer (SBBC) patients treated with adjuvant radiotherapy (RT) by Volumetric 
      Modulated Arc Therapy (VMAT). METHODS: From September 2011 to April 2016, 1100 
      Breast Cancer (BC) patients were referred to our institution to receive adjuvant 
      breast RT, and those with SBBC were selected for the present analysis. A total of 
      16 patients were identified. A total dose of 50 Gy in 25 fractions was prescribed 
      to the Planning Target Volume of the whole bilateral breast (PTV(BN)) with or 
      without the supraclavicular and infraclavicular nodes, while a total dose of 
      60 Gy in 25 fractions was prescribed to the surgical bed (PTV(boost)). Several V 
      (xGy) and Dx% parameters were analyzed for the PTVs, together with Conformity and 
      Homogeneity indexes (CI, HI), and for the critical Organs at risk (OARs), lungs 
      and heart first. RESULTS: With a median follow-up of 24 months, no acute or late 
      side effects more than grade 2 were observed. All patients are alive without any 
      sign of disease. For target dose coverage, our observed inter-patients averages 
      (+/-1 sd) were V (95% Dp) = 96.7 +/- 1.6% (96.3 +/- 1.8%) to the left (right) PTV(BN), 
      V (95% Dp) = 98.6 +/- 2.7% (99.4 +/- 0.9%) to the left (right) PTV(boost), and D 
      (2%) = 64.4 +/- 1.8 Gy (65.0 +/- 2.0 Gy) to the left (right) PTV(boost), 
      respectively. With regard to the heart, the inter-patient average of D (mean) was 
      8.3 +/- 3.3 Gy. For the lungs, the inter-patient average of D (mean), V (5 Gy) and 
      V (20 Gy) were 11.8 +/- 2.3 Gy, 78.9 +/- 15.3% and 15.7 +/- 5%, respectively. 
      CONCLUSIONS: The present retrospective analysis showed the feasibility, 
      tolerability and safety of VMAT in the treatment of SBBC patients. Further 
      studies are necessary to confirm these preliminary data.
FAU - Fiorentino, Alba
AU  - Fiorentino A
AD  - Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, via Don 
      Sempreboni 5, 37034, Negrar, Verona, Italy.
FAU - Mazzola, Rosario
AU  - Mazzola R
AD  - Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, via Don 
      Sempreboni 5, 37034, Negrar, Verona, Italy. rosariomazzola@hotmail.it.
FAU - Naccarato, Stefania
AU  - Naccarato S
AD  - Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, via Don 
      Sempreboni 5, 37034, Negrar, Verona, Italy.
FAU - Giaj-Levra, Niccolo
AU  - Giaj-Levra N
AD  - Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, via Don 
      Sempreboni 5, 37034, Negrar, Verona, Italy.
FAU - Fersino, Sergio
AU  - Fersino S
AD  - Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, via Don 
      Sempreboni 5, 37034, Negrar, Verona, Italy.
FAU - Sicignano, Gianluisa
AU  - Sicignano G
AD  - Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, via Don 
      Sempreboni 5, 37034, Negrar, Verona, Italy.
FAU - Tebano, Umberto
AU  - Tebano U
AD  - Radiation Oncology School, University of Padua, Padua, Italy.
FAU - Ricchetti, Francesco
AU  - Ricchetti F
AD  - Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, via Don 
      Sempreboni 5, 37034, Negrar, Verona, Italy.
FAU - Ruggieri, Ruggero
AU  - Ruggieri R
AD  - Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, via Don 
      Sempreboni 5, 37034, Negrar, Verona, Italy.
FAU - Alongi, Filippo
AU  - Alongi F
AD  - Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, via Don 
      Sempreboni 5, 37034, Negrar, Verona, Italy.
LA  - eng
PT  - Journal Article
DEP - 20170221
PL  - Italy
TA  - Radiol Med
JT  - La Radiologia medica
JID - 0177625
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Breast Neoplasms/*radiotherapy
MH  - Feasibility Studies
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - Radiotherapy Dosage
MH  - Radiotherapy, Adjuvant
MH  - *Radiotherapy, Intensity-Modulated/methods
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Bilateral breast cancer
OT  - Breast radiotherapy
OT  - Nodal irradiation
OT  - Simultaneous integrated boost
OT  - VMAT
EDAT- 2017/02/23 06:00
MHDA- 2017/06/21 06:00
CRDT- 2017/02/23 06:00
PHST- 2016/08/22 00:00 [received]
PHST- 2017/02/06 00:00 [accepted]
PHST- 2017/02/23 06:00 [pubmed]
PHST- 2017/06/21 06:00 [medline]
PHST- 2017/02/23 06:00 [entrez]
AID - 10.1007/s11547-017-0741-y [pii]
AID - 10.1007/s11547-017-0741-y [doi]
PST - ppublish
SO  - Radiol Med. 2017 Jun;122(6):464-471. doi: 10.1007/s11547-017-0741-y. Epub 2017 
      Feb 21.