Half-Body Irradiation With Tomotherapy for Pain Palliation in Metastatic Breast Cancer

Abstract

Lower HBI delivered with helical tomotherapy resulted in a well-tolerated regimen, without significant delay in chemotherapy schedule.

Retrospective analysis of the effectiveness of volumetric modulated arc therapy half‑body irradiation in palliation of pain in patients with multiple bone metastases

“…Our retrospective study shows that VMAT-based HBI is effective in palliation of pain, with relief in all measured scales of pain. Our findings are similar to results by another authors (8)(9)(10)12,13,16) are consistent with two prospective trials, where pain relief was reported in 76 and 73% of patients undergoing HBI (9,12). However, in both trials, radiotherapy was applied in less conformal techniques.…”

“…The risk of radiation-induced pneumonitis, which tends to increase when a dose absorbed to a lung is higher than 6 Gy, is now lower (14). What is more, with the application of conformal techniques, doses to all OARs are reduced in comparison to those prescribed to PTV (8).…”

“…avoid unaffected bones. Thus, it helps to reduce doses in organs at risk and may decrease the incidence of acute toxicity (8). The safest and most effective single HBI doses are 6 Gy for UHBI and 8 Gy for both LHBI and MBI (12).…”

“…Half-body irradiation (HBI) is an alternative to local field radiotherapy. It shortens treatment time and its pain palliation is effective (8)(9)(10). Historically, HBI was categorized into upper HBI (UHBI), lower HBI (LHBI) and mid-body irradiation (MBI) (11).…”

A novel Hemi-Body Irradiation technique using electron beams (HBIe−)

“…As shown in Figure 2, the patients' immobilization system and a plexiglass slab (for the appropriate degrading of the beam's mean energy and widening of the fields) were fitted in a custom built chamber. Current half body irradiation techniques are used mainly for palliative purposes in metastatic diseases (prostate, lung and breast cancers) and involve photons as source of radiation [18][19][20][21][22][23][24][25][26]. In most of the cases, x-rays produced by linacs, γ rays produced by Cobalt Units [22] and even UVB rays, in phototherapy studies [24,] were utilized, yet only for highly palliative treatments in patients with a very short life expectancy (bony metastatic cancer [5,22,23], acute leukemia [25], metastatic carcinoma of the prostate [26]).…”