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Intensity modulated radiation therapy for breast cancer: current perspectives

Authors Buwenge M, Cammelli S, Ammendolia I, Tolento G, Zamagni A, Arcelli A, Macchia G, Deodato F, Cilla S, Morganti AG

Received 12 December 2016

Accepted for publication 7 February 2017

Published 6 March 2017 Volume 2017:9 Pages 121—126

DOI https://doi.org/10.2147/BCTT.S113025

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 2

Editor who approved publication: Professor Pranela Rameshwar

Milly Buwenge,1 Silvia Cammelli,1 Ilario Ammendolia,1 Giorgio Tolento,1 Alice Zamagni,1 Alessandra Arcelli,2 Gabriella Macchia,3 Francesco Deodato,3 Savino Cilla,4 Alessio G Morganti1

1Department of Experimental, Diagnostic and Specialty Medicine – DIMES, Radiation Oncology Center, University of Bologna, S.Orsola-Malpighi Hospital, 2Radiation Oncology Unit, Bellaria Hospital, Bologna, 3Radiation Oncology Unit, 4Medical Physics Unit, Research and Care Foundation ‘Giovanni Paolo II,’ Catholic University of Sacred Heart, Campobasso, Italy

Background: Owing to highly conformed dose distribution, intensity modulated radiation therapy (IMRT) has the potential to improve treatment results of radiotherapy (RT). Postoperative RT is a standard adjuvant treatment in conservative treatment of breast cancer (BC). The aim of this review is to analyze available evidence from randomized controlled trials (RCTs) on IMRT in BC, particularly in terms of reduction of side effects.
Methods: A literature search of the bibliographic database PubMed, from January 1990 through November 2016, was performed. Only RCTs published in English were included.
Results: Ten articles reporting data from 5 RCTs fulfilled the selection criteria and were included in our review. Three out of 5 studies enrolled only selected patients in terms of increased risk of toxicity. Three studies compared IMRT with standard tangential RT. One study compared the results of IMRT in the supine versus the prone position, and one study compared standard treatment with accelerated partial breast IMRT. Three studies reported reduced acute and/or late toxicity using IMRT compared with standard RT. No study reported improved quality of life.
Conclusion: IMRT seems able to reduce toxicity in selected patients treated with postoperative RT for BC. Further analyses are needed to better define patients who are candidates for this treatment modality.

Keywords: intensity modulated radiation therapy, breast cancer, literature review

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