Advances in Radiation Oncology | 2021
New Technologies and Multidisciplinarity as Strategic Factors to Cope With Challenges in Postmastectomy Breast Cancer Radiation Therapy
Abstract
Postmastectomy radiation therapy (PMRT) reduces the risk of breast cancer recurrence and mortality in patients with node-positive breast cancer. However, PMRT to the left chest wall and regional lymph nodes often poses technical challenges owing to irregular surface contours, large curvature, and a near-surface target. Adequate irradiation of target volumes should never penalize the sparing of the adjacent organs at risk (OARs). Modern technologies such as the Active Breathing Coordinator (ABC) device, the AlignRT surface imaging system (by X X VisionRT), volumetric arc therapy (VMAT), and the automated planning (AP) module of the Pinnacle3 treatment planning system represent key tools to overcome several hurdles in this complex setting. To our knowledge, the simultaneous use of these techniques and devices has not been reported.