Radiotherapy approaches for tumour bed boost in breast cancer
Authors: Tomas Kron
Institution: Peter MacCallum Cancer Centre, Melbourne, Australia
Introduction
Motion management for radiotherapy in breast cancer: necessity or waste of time? Modern radiotherapy benefits from the ability to deliver dose distributions that are highly conformal to the identified target region whilst minimising dose to surrounding healthy structures. Target and organ motion can affect this targeting ability and breathing, and to a lesser extent cardiac motion is of relevance for breast cancer radiotherapy.
Methods
Several methods have been introduced to manage breathing motion. While gated delivery is rarely used, breath-hold has been demonstrated to reduce cardiac and lung dose consistently, in particular in left-sided breast cancer patients. Methods to monitor successful motion management, for example, optical surface guidance, have improved over the last decade and provide confidence that the treatment is delivered as planned. However, motion management requires additional resources and may prolong treatment time.
Results
The presentation will review different motion management strategies and examine their implementation options with particular reference to breath-hold strategies. The primary aim of motion management in breast cancer is to reduce late toxicities and the induction of secondary malignancies. As the importance of non-cancer radiation detriment, in particular cardiovascular problems and immune effects, is increasingly recognised, motion management is likely to become part of treatment for all breast cancer patients that can benefit from radiotherapy.
Conclusion
As the importance of non-cancer radiation detriment, in particular cardiovascular problems and immune effects, is increasingly recognised, motion management is likely to become part of treatment for all breast cancer patients that can benefit from radiotherapy.