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Clinical audit of breast cancer patients treated with helical tomotherapy for irradiation of the internal mammary chain

Published online by Cambridge University Press:  28 March 2022

Garima Shrivastav ,
Debanjali Datta Open the ORCID record for Debanjali Datta [Opens in a new window] ,
Tabassum Wadasadawala Open the ORCID record for Tabassum Wadasadawala [Opens in a new window] ,
Pallavi Rane ,
Subhajit Panda ,
Rima Pathak ,
Libin Scaria ,
Revathy Krishnamurthy  and
Rajiv Sarin
Garima Shrivastav
Affiliation:
Department of Radiation Oncology, ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Kharghar, Navi Mumbai, India
Debanjali Datta
Affiliation:
Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, India
Tabassum Wadasadawala*
Affiliation:
Department of Radiation Oncology, ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Kharghar, Navi Mumbai, India
Pallavi Rane
Affiliation:
Department of Clinical Research and Statistics, ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Kharghar, Navi Mumbai, India
Subhajit Panda
Affiliation:
Department of Radiation Oncology, ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Kharghar, Navi Mumbai, India
Rima Pathak
Affiliation:
Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, India
Libin Scaria
Affiliation:
Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, India
Revathy Krishnamurthy
Affiliation:
Department of Radiation Oncology, ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Kharghar, Navi Mumbai, India
Rajiv Sarin
Affiliation:
Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, India
*
Author for correspondence: Dr Tabassum Wadasadawala, Radiation Oncology, ACTREC, Tata Memorial Centre, CISF Road, Near Central Park, Kharghar, Navi Mumbai 410210, India. Tel: 91 22 27405079. Fax: 91 22 2740 5085. E-mail: [email protected]
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Abstract

Aim:

To evaluate efficacy of helical tomotherapy (HT) for treatment of breast cancer with internal mammary lymph node involvement.

Methods:

This is a retrospective clinical audit of planning, dosimetry, toxicity and short-term survival of a cohort of 65 patients. Patients were treated between November 2014 and May 2019. The primary and nodal region was prescribed a dose of 50 Gray (Gy) in 25 fractions, while all cases of breast conserving surgery received a simultaneous integrated boost to a dose of 61 Gy in 25 fractions.

Results:

The 95% coverage for the primary, supraclavicular, internal mammary node and tumour bed was 93·4%, 96·8%, 90·7% and 98·3%, respectively. Mean dose to total lung, heart and contra-lateral breast was 10·6 Gy, 6·92 Gy and 4·32 Gy, respectively. None developed grade III skin or oesophageal toxicity. Twenty-one patients had progression; of which eighteen developed only distant failure while three also had loco-regional recurrence. At a median follow-up of 36 months, the 3-year loco-regional control, disease-free survival and overall survival were 93·5, 73·9 and 85·9%, respectively.

Conclusion:

We report encouraging clinical outcome for patients treated uniformly with HT. The predominant pattern of failure was distant metastases which suggests the need for systemic control intensification.

Keywords

breast cancerHelical TomotherapyInternal mammary nodal irradiation
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 22 , 2023 , e23
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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