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Posted by on Jul 12, 2020 in Breast cancer | 0 comments

In a nutshell

The study evaluated long-term outcomes of combining hypofractionated intensity-modulated radiation therapy (H-IMRT) with prone-positioning in patients after conservation surgery for breast cancer. The authors found that this combination safely controlled cancer locally without affecting regional lymph nodes.

Some background

Adjuvant radiation is given as additional therapy in patients with conserved breast cancer. Breast conservation (BC) refers to removing the tumor only, without whole breast surgery. At prone-position (PP) patients lie with their chests down and backs up. H-IMRT contains few high-intensity radiation doses to precisely destroy any remaining cancer cells without harming surrounding tissues. H-IMRT at PP as an adjuvant recently showed benefits with minimal toxicities in patients after BC. However, its long-term effects are unclear.

Methods & findings

The study included 489 patients who had breast conservation surgery. All patients were then treated with adjuvant H-IMRT at PP. 155 of them were followed up for 52 months on average after radiation.

Local recurrence (LR) means the return of cancer in the same place where it first started. All patients survived for 5 years without any LR. 98.2% of patients survived without cancer’s spread to regional lymph nodes in 5 years. 6 patients developed cancer in distant organs during this time.

Breast discomfort was the most common long-term side effect. It occurred in 21.3% of patients. Occasional and mild breast pain happened in 20% of patients. 1.3% of patients required analgesics for moderate breast pain. 11% had new pain after radiation.

Mild soft-tissue fibrosis (STF; scar tissue forming) occurred in 12.3% of patients. It was the second most common long-term effect. No patient faced inflammation and fibrosis in lungs, rib fracture, or heart disorders, as late side-effects. Cosmetic changes in breasts due to treatment were described as minimal by all patients. 9 (5.8%) patients developed another type of cancer. after a minimum of 5 years.

The bottom line

The study concluded that H-IMRT at PP after breast conservation surgery was beneficial to control breast cancer locally and prevent its spread to regional lymph nodes and was well tolerated.

The fine print

This was the largest study evaluating the long-term effects of this combination. It also looked back in time to analyze patients’ records.

Published By :

Journal of medical imaging and radiation oncology

Date :

Jun 16, 2020

Original Title :

Long-term outcomes of patients with conserved breast cancer treated with adjuvant hypofractionated prone breast intensity-modulated radiation therapy.

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