Computed tomography (CT) scan evaluation of late toxicity following hypofractionated/accelerated radiotherapy with cytoprotection (HypoARC) in breast cancer patients treated with conservative surgery.
BACKGROUND
In the present study we evaluated the long-term radiation toxicity of an hypofractionated accelerated radiotherapy scheme supported with amifostine cytoprotection (hypoARC).


METHODS
A cohort of 32 breast cancer patients, pretreated with conservative surgery and adjuvant doxorubicin or taxane based chemotherapy, were treated with hypoARC. In contrast to the 45 days required for the delivery of standard breast (+/-supraclavicular) radiotherapy, the proposed scheme delivers the whole radiation dose in 16 days (10 fractions of 3.5Gy plus 2 additional 4Gy fractions to the tumor bed), which is convenient for elderly patients or patients residing away from radiotherapy departments.


RESULTS
After a minimum follow up of 24 months (range, 24-36), none of the patients showed any clinical signs of lung or arm toxicity. Increased palpable breast density was evident 16 out of 32 cases. Computed tomography (CT) scan evaluation of the lung and breast densities (calculated in Haunsfield units) showed no signs of lung fibrosis, while increased density of the irradiated breast (1.1-1.3-fold) was confirmed in 8 out of 17 patients examined. None of the patients has relapsed locally.


CONCLUSIONS
Although longer follow-up is required to confirm safety of the described radiotherapy regimen, these data are encouraging as the toxicity reported within 2 to 3 years of follow-up is even lower than the one expected from standard radiotherapy.
Manavis
John
J
Department of Radiology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
Ambatzoglou
John
J
Sismanidou
Kyriaki
K
Koukourakis
Michael I
MI
D000328:Adult; D000368:Aged; D004999:Amifostine / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001940:Breast / Q000528:radiation effects; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000601:surgery; D015331:Cohort Studies; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000528:radiation effects; D008875:Middle Aged; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control*; D011837:Radiation-Protective Agents / Q000627:therapeutic use*; D011878:Radiotherapy / Q000009:adverse effects; D020266:Radiotherapy, Conformal; D014057:Tomography, X-Ray Computed
D000970:Antineoplastic Agents; D011837:Radiation-Protective Agents; D004999:Amifostine