Intensity-modulated and hypofractionated simultaneous integrated boost adjuvant breast radiation employing statics ports of tomotherapy (TomoDirect): a prospective phase II trial

Abstract

Hypofractionated IM-WBRT with a SIB to the tumor bed delivered with TD provides consistent clinical results and it is able to reduce acute skin toxicity rate over conventionally fractionated and sequential boost tomotherapy-based IM-WBRT.

Intensity-Modulated Radiation Therapy with Simultaneous Integrated Boost Combined with Concurrent Chemotherapy for the Treatment of Anal Cancer Patients: 4-Year Results of a Consecutive Case Series

“…In adjunct, we employed a SIB approach as in the RTOG 0529 trial, allowing for the delivery of a different daily dose to selected treatment volumes during the same treatment fraction. SIB has been demonstrated to provide dosimetric benefits in terms of target volume dose conformity and homogeneity and normal tissue sparing in the setting of both head and neck and breast cancer (26)(27)(28). This advantage may be postulated also for anal cancer.…”

Tumor Bed Boost Integration during Whole Breast Radiotherapy: A Review of the Current Evidence

“…In that cohort of 120 patients, more than 1/3 of the whole breast received 105% of the prescribed dose, almost 1/5 received 110%, and more than 1/10 received 115%, due to the sequential boost phase. In a subsequent phase II trial, Franco et al [29] employed a static angle tomotherapy approach to deliver hypofractionated SIB WBRT achieving consistent dosimetric results as V 105% (for whole breast planning target volume (PTV) minus tumor bed PTV) was very low (2.4 ± 0.9) and V 110% negligible (0.01), strongly limiting unintended irradiation outside the tumor bed. These dosimetric results were reflected by a robust reduction in acute skin toxicity.…”

“Simplicity is complexity resolved”: the case of postoperative radiation therapy after breast conservation

“…Overall, the side-effects of adjuvant systemic therapy are expected to outweigh those of WBRT, especially as new developments in the field of radiation oncology substantially decreased the burden of radiation therapy (10). Hypofractionated schedules of WBRT and accelerated partial breast irradiation provide new options to decrease overall treatment time, cost, inconvenience, and toxicity of postoperative radiation (17)(18)(19).…”