RESUMO
PURPOSE: The purpose of this study was to evaluate acute skin toxicity in early breast cancer patients treated with hypofractionated radiotherapy (HFRT) after breast-conserving surgery and to identify factors predictive for grade ≥â¯2 acute skin toxicity. MATERIALS AND METHODS: A monocentric retrospective study was carried out using cases treated between December 2017 and November 2020. We analyzed data from 202 patients with early breast cancer treated with 3D hypofractionated RT (40.05â¯Gy in 15 fractions) to the whole breast with or without regional lymph nodes, followed by 13.35â¯Gy in 5 fractions to the tumor bed. Acute skin toxicity was monitored during RT according to CTCAE (common toxicity criteria for adverse events) scale. Univariate and multivariate analyses were performed to assess predictive factors of acute skin toxicity. RESULTS: Overall, there was no erythema in 9%, grade 1 erythema in 64.5%, grade 2 in 24%, and grade 3 in 2.5%. No grade 4 erythema was seen. Median delay between RT initiating and maximum skin reaction was 22 days (range 4-44 days). No patient interrupted treatment. In univariate analysis, the rate of acute skin toxicity grade 2---3 (G2-3) was significantly higher for patients with larger tumor size (pâ¯= 0.02), body mass index >â¯27 (pâ¯= 0.04), and time between chemotherapy (CT) and RT less than 20 days (pâ¯= 0.01). Dosimetric risk factors for acute skin toxicity G23 were breast volume >â¯800â¯cc (pâ¯= 0.000), boost volume >â¯18â¯cc (pâ¯= 0.002), V105% >â¯40â¯cc (pâ¯= 0.03), and Dmax >â¯56â¯Gy (pâ¯= 0.007). CT, trastuzumab, regional lymph node radiation, and age were not correlated with increased skin toxicity. In multivariate analysis, acute skin toxicity correlated with T stage (pâ¯= 0.032), breast volume >â¯800â¯cc (pâ¯= 0.012), boost volume >â¯18â¯cc (pâ¯= 0.04), and Dmax >â¯56â¯Gy (pâ¯= 0.035). CONCLUSION: Our results confirm that whole breast with or without lymph nodes hypofractionated RT is safe and well tolerated. The factors strongly associated with a decreased risk of G23 skin toxicity are T1, breast volume <â¯800â¯c, boost volume <â¯18â¯cc, and Dmax <â¯56â¯Gy. Long-term follow-up is needed to evaluate late toxicity.
Assuntos
Neoplasias da Mama , Mastectomia Segmentar , Humanos , Feminino , Estudos Retrospectivos , Estadiamento de Neoplasias , Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Neoplasias da Mama/patologia , Mama/patologia , Radioterapia Adjuvante/efeitos adversos , Radioterapia Adjuvante/métodosRESUMO
Primary central nervous system neuroblastoma is a rare malignant embryonal tumor. With only few cases reported in the literature, data on regardingthe diagnosis and management of these tumors are limited. We reported a case of primary cerebral neuroblastoma in a 20-year-old woman complaining of progressive headaches. The patient underwent subtotal tumor resection and adjuvant concurrent chemoradiotherapy. The prescription dose was 54 Gy. She remained free of recurrence for 14 months after the end of radiotherapy treatment.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica , Neuroblastoma , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Sistema Nervoso Central , Quimiorradioterapia , Feminino , Humanos , Neuroblastoma/terapia , Adulto JovemRESUMO
In patients with cardiac implantable electronic devices CIEDs, including cardiac pacemakers (PM) and implantable cardioverter-defibrillators (ICD), radiotherapy (RT) could compromise CIED function. Managing radiotherapy patients with CIED, has been a great practical and procedural challenge in radiotherapy and requires a structured multidisciplinary approach. A consensus document is presented as a result of a multidisciplinary working group involving cardiac electrophysiologists, Radiation Oncologists and Medical physicists. It aims to propose recommendations on risk stratification, management approach before, during and after radiation treatment/course of patients with CIED.