Impact of adjuvant radiotherapy on biological and clinical parameters in right-sided breast cancer.

Lauffer, D C; Miglierini, P; Kuhn, P A; Thalmann, S U; Gutierres-Demierre, N; Khomsi, F; Tercier, P-A; Allal, A S (2021). Impact of adjuvant radiotherapy on biological and clinical parameters in right-sided breast cancer. Cancer radiothérapie, 25(5), pp. 469-475. Elsevier Science 10.1016/j.canrad.2021.04.007

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PURPOSE

In patients with right-sided breast cancer (BC) the liver might be partially irradiated during adjuvant radiotherapy (RT). Thus, we performed a prospective observational study to evaluate the dose delivered to the liver, and its potential biological impact.

PATIENTS AND METHODS

We enrolled 34 patients with right-sided BC treated with adjuvant RT. The RT schedules were either the Canadian (42.5Gy in 16 fx) or standard fractionated (50Gy in 25 fx) regimen respectively with 9 (26.5%) and 25 (73.5%) patients each, ± a boost of 10-16Gy. Each patient had a complete blood count and liver enzymes analysis, before starting and during the last week of treatment.

RESULTS

A significant decrease in white blood cells and thrombocytes counts was observed during RT. We observed a significant correlation between certain hepatic parameters and the volume of the irradiated liver and/or the mean liver dose. A significant correlation between the volume of the right lung and the liver mean dose was found (P=0.008). In the bivariate analysis, a significant correlation between fatigue and the white blood cell count's evolution was observed (P<0.025).

CONCLUSION

With the standard RT technique, incidental irradiation of the liver was documented in a large number of patients, and some significant hepatic parameters alterations were observed, without an apparent clinical impact, but this study cannot exclude them. The liver mean dose was correlated with the right lung volume suggesting that deep inspiration breath hold (DIBH) techniques may represent a way to decrease the liver dose. These findings need to be evaluated in further larger studies.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology

UniBE Contributor:

Lauffer, David

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1769-6658

Publisher:

Elsevier Science

Language:

English

Submitter:

Beatrice Scheidegger

Date Deposited:

22 Jun 2021 14:08

Last Modified:

05 Dec 2022 15:51

Publisher DOI:

10.1016/j.canrad.2021.04.007

PubMed ID:

34120853

Uncontrolled Keywords:

Cancer du sein droit Deep inspiration breath hold Foie Inspiration profonde bloquée Liver Radiation-induced liver disease Radiotherapy Radiothérapie Right-sided breast cancer Toxicity Toxicités

BORIS DOI:

10.48350/156950

URI:

https://boris.unibe.ch/id/eprint/156950

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