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In vivo dosimetry and acute toxicity in breast cancer patients undergoing intraoperative radiotherapy as boost

Other Titles
 유방암 환자에서 수술 중 방사선치료를 boost로 사용하는 것에 대한 생체 내 선량 측정 및 급성 독성에 대한 연구 
 College of Medicine (의과대학) 
 Others (기타) 
Issue Date
Purpose: To report the results of a correlation analysis of skin dose assessed by in vivo dosimetry and the incidence of acute toxicity. This is a phase 2 trial evaluating the feasibility of intraoperative radiotherapy (IORT) as a boost for breast cancer patients. Materials and Methods: Eligible patients were treated with IORT of 20 Gy followed by whole breast irradiation (WBI) of 46 Gy. A total of 55 patients with a minimum follow-up of 1 month after WBI were evaluated. Optically stimulated luminescence dosimeter (OSLD) detected radiation dose delivered to the skin during IORT. Acute toxicity was recorded according to the Common Terminology Criteria for Adverse Events V4.0. Clinical parameters were correlated with seroma formation and maximum skin dose. Results: Median follow-up after IORT was 25.9 weeks (range, 12.7-50.3). Prior to WBI, only 1 patient developed acute toxicity. Following WBI, 30 patients experienced grade 1 skin toxicity and 3 patients had grade 2 skin toxicity. Skin dose during IORT exceeded 5 Gy in 2 patients: with grade 2 complications around the surgical scar in 1 patient who received 8.42 Gy. Breast volume on preoperative images (p = 0.001), ratio of applicator diameter and breast volume (p = 0.002), and distance between skin and tumor (p = 0.003) showed significant correlations with maximum skin dose. Conclusion: IORT as a boost was well-tolerated among Korean women without severe acute complication. In vivo dosimetry with OSLD can help ensure safe delivery of IORT as a boost.
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