Radiation Oncology/Breast/RT toxicity

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Front Page: Radiation Oncology | RTOG Trials

Breast: Main Page | Staging | Breast Overview | Prevention | Benign | DCIS | LCIS | Paget's | Phyllodes tumor | Early stage | Advanced stage | Post mastectomy | Inflammatory | Partial breast irradiation | Regional lymphatics | Hormonal therapy | Chemotherapy | RT technique | Recurrence | Toxicity of RT | Randomized | NSABP trials

[edit] Heart

See also: Radiation Oncology/Toxicity/Heart

Dosimetric studies:

  • King's College (UK), (1957-89)
    • PMID 1410585, 1992 — "Cardiac doses in post-operative breast irradiation." Fuller SA et al. Radiother Oncol. 1992 Sep;25(1):19-24.
    • 28 pts, stage I-II. 14 were from 1957-84 and 14 from 1988-9. Recorded dose to total cardiac volume and three main coronary arteries


[edit] Lymphedema

  • MGH, 2003 (1982-1995) PMID 12654429 -- "Risk of lymphedema after regional nodal irradiation with breast conservation therapy." (Coen JJ, Int J Radiat Oncol Biol Phys. 2003 Apr 1;55(5):1209-15.)
    • Retrospective. 727 Stage I-II BCA patients treated with BCT. Lymphedema defined >2 cm difference in forearm circumference. Breast RT alone 68%, Breast + lymphatics RT 32%. Most Level I-II axillary dissection. Median F/U 6 years
    • 10-year outcome: 4% (tangents alone 2% vs. axillary 9%, SS)
    • Predictors for lymphedema: only axillary irradiation
    • Conclusion: Risk lower than generally recognized
  • NSABP B-04, PMID 18029105 — "The Incidence of Arm Edema in Women With Breast Cancer Randomized on the National Surgical Adjuvant Breast and Bowel Project Study B-04 to Radical Mastectomy Versus Total Mastectomy and Radiotherapy Versus Total Mastectomy Alone." (Deutsch M et al. Int J Radiat Oncol Biol Phys. 2008 Mar 15;70(4):1020-1024.)
    For more information see page at Axilla
    • Halsted radical mastectomy (RM) vs. total mastectomy + RT (TM+RT) vs. TM alone. Recorded ipsilateral and contralateral arm circumference every 3 months (avg of >= 6 sets of measurements per pt).
    • Increase of >=2cm in arm circumference was seen in 58.1% (RM), 38.2% (TM+RT) vs 49.1% (TM). Severe edema (>=4cm) in 21.5%, 11.4%, and 13.1%. 25% with edema at one time had no edema at the time of final measurement. Increased BMI associated with edema.
    • High incidence of edema with these surgical techniques.

[edit] Pneumonitis

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