Median elapsed time between initial and reirradiation courses was 9.7 years (range, 0.9-37.6). The second course of radiation used proton therapy in all patients. Among the 7 of 27 patients with available records (5/7 with acute toxicity records, 2 of 7 with late toxicity records), no grade 3 acute or late toxicities were recorded from the first course of radiation. The remaining patients were treated to the breast (15/27), breast and regional nodes (6/27), and chest wall and regional nodes (3/27, regional nodal treatment records NA in an additional 1/27).
In 1 patient with breast cancer, 20 Gy/5 fractions were delivered to the thoracic spine and ribs for metastatic disease, also overlapping the reirradiation field. In 1 patient with HL, 35 Gy/20 fractions involved field RT was delivered to the cervical nodes and mediastinum, which overlapped with the subsequent reirradiation field. The initial radiation course was 15 whole breast (WB), 10 whole breast/chest wall (WB/CW) and regional nodes, 1 involved field treatment for Hodgkin lymphoma (HL), and 1 palliative thoracic spine treatment. The first radiation course was delivered using photons, with or without electrons, in all patients. Common Terminology Criteria for Adverse Events version 4.0 toxicity grading was used.įirst RT dose (cGy) initial + boost total/fx sizeĪcute and late grade 3 dermatitis and breast pain Acute and late toxicities were determined from clinician visit notes, including physician or nurse toxicity grading, and other available clinical data. All patients were seen for weekly on-treatment visits, and follow-up visits were generally scheduled 3 months after treatment and then every 6 months for clinician toxicity assessment. Data were abstracted from the electronic medical record and external record chart review.
The study was approved by the institutional review board at our institution. Patients with both metastatic and logoregional disease were included. This single-institution, retrospective study includes 27 patients treated with proton reirradiation between 20 who met the following inclusion criteria: LRR of breast cancer, prior photon radiation to the same region where reirradiation had substantial and direct overlap in the opinion of the treating radiation oncologist, proton beam reirradiation, and definitive intent, defined as treated to a reirradiation dose of at least 42 Gy.
0 kommentar(er)
