Adjuvant radiotherapy after surgery in breast cancer: evaluation of acute toxicity

Introduction

Postoperative irradiation of conservatively operated breast carcinoma is one of the most common practice in radiation oncology. In this job we analyze the acute toxicity during treatment.

Materials and method

From 1999 to January 2003, 220 patients aged 31–71 (median, 55.8) with breast cancer in stage I and II after conservative surgery were studied. Menopause was induced in 75 of the patients with hormonal therapy. Radiation therapy of the breast after quadrantectomy is based on the use of lateral and medial tangential portals. With the advent of conformal 3D-treatment planning precise physical dose localization can be achieved optimizing the dose distribution. The definition of the volume target and the elaboration of the treatment plan were executed on computed tomography scans. A total dose of 50 Gy is given to the whole breast and followed by a 10 Gy boost. In the patients with neoplastic involvement of the lymph nodes, chemotherapy treatment and/or endocrine therapy was instituted. The analysis of the acute toxicity was valuated with scale EORTC RTOG.

Results and conclusion

Postoperative radiotherapy was well tolerated on its own and concomitant with chemotherapy. The cutaneous acute toxicity in patients managed with single radiotherapy was as follows: G0 = 5.6%, G1 = 17.6%, G2 = 4.8% and G3 = 0.6%. For patients managed with OT the cutaneous acute toxicity was as follows: G0 = 4.8%, G1 = 22.2%, G2 = 5.8% and G3 = 0.6%. For patients managed with CT the cutaneous acute toxicity was as follows: G0 = 4.7%, G1 = 23.6%, G2 = 0.8% and G3 = 1.6%. Differences in acute cutaneous toxicity between different outlines of CT did not emerge. Pulmonary and/or cardiac acute reactions were not found.