Avaliação de um esquema alternativo de aplicação da dose de reforço de radioterapia (BOOST) em pacientes com câncer de mama visando diminuir o tempo total de tratamento

Abstract

Background: radiotherapy is an essential part of the conservative treatment of breast cancer. Standard treatment involves a dose of approximately 50 Gy to the whole breast, and a boost of about 10 Gy to the tumor bed. Throughout this dose fractionation radiotherapy frequently hampers the choice of conservative treatment, or treatment compliance. Alternative fractionation schemes can reduce the total treatment time. Objectives: the objectives of this study are to evaluate the reproducibility of an alternative scheme for the delivery of the boost dose aiming on reducing the total treatment time, to evaluate the acute and sub acutetoxicity of such fractionation, and assess the final cosmetic result. Patients and Methods: forty-three patients received a fractionation scheme with 50.4 Gy in 28 fractions over the entire breast and a weekly boost of 1.12 Gy on the tumor bed, for six weeks. The reproducibility of the treatment was evaluated. Patients were accessed for demographic and social data, acute and sub acute side effects, and the final cosmetic result. Results: the study was considered reproducible, and none of the boost fractions were omitted. The incidence of grade 2 or higher sideeffects was 26% at the end of the treatment, and only 16% after 6 months followup. The final cosmetic result was excellent or good in 97% of the cases. Conclusion: the proposed fractionation schedule is reproducible, and produces a low incidence of relevant side effects, with excellent esthetic results.