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Federación Mexicana de Ginecología y Obstetricia, A.C.

2016, Number 07

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Ginecol Obstet Mex 2016; 84 (07)

Fractionated stereotactic radiotherapy with Cyberknife® as a model of accelerated partial breast irradiation in Mexico. Dissymmetry and acute morbidity

Ortiz-Arce CS, Chagoya-González A, Olmedo-Valladares E, Velázquez-Trejo JJ, Gutiérrez-Márquez JG, Madrid-González OA, Huerta-Bahena J

Language: Spanish
References: 15
Page: 420-427
PDF size: 363.48 Kb.


ABSTRACT

Background: Actually the breast cancer is more and more diagnosed at early stage. For those cases, breast conservative treatment (breast conserving surgery followed by whole breast irradiation) is commonly used since many years. New radiation modalities particularly accelerated partial breast irradiation, have been recently developed in a subgroup of patients with early breast cancers who present clinical characteristics associated with low rates of local recurrence.
Objetive: We present the technique and our first results using radiosurgery with CyberKnife® as a model of accelerated partial breast irradiation.
Methods: Clinical, prospective, randomized and comparative study of partial irradiation techniques in the breast was made, including an arm for treatment with fractionated stereotactic radiotherapy with CyberKnife® in two different doses: 1) 22.5 Gy in 3 Fx , and 2) of 30 Gy in 5 Fx, with BED 45 and 50 Gy , respectively. To evaluate the aesthetic results digital photographs were taken before starting and after end of treatment. The analysis of variance one-way and Tukey test was used to assess dosimetry, conformality, uniformity and doses received in the “risk organ”.
Results: In 95% of planning volume was covered with top isodose 70%, with average coverage of 97%. Conformality and new conformality index of 1.28 and 1.34 were for doses of 22.5 Gy and 30 Gy, respectively. Acute dermal morbidity was Grade I, mainly in the quadrant of the breast treated with partial irradiation. After a year of follow-up, we observed a patient with breast faillure outside of the quadrant treated with partial irradiation.
Conclusion: Fractionated stereotactic radiotherapy with CyberKnife ® is a safe and effective alternative in patients with breast cancer in early clinical stages treated with conservative surgery.


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