Original ArticleImplant risk failure in patients undergoing postmastectomy 3-week hypofractionated radiotherapy after immediate reconstruction
Section snippets
Materials and methods
This investigation is a part of the research project on IMRT and hypofractionation on breast cancer notified to the Ethical Committee of the European Institute of Oncology (IEO) (26 May 2016, Milan, Italy) and approved by the review board. This is a retrospective study, whose data are collected in a dedicated RT databank (RTP R039-000-Tomotherapy-breast) and continually updated. All the patients gave written informed consent for treatment and for use of their anonymized data for educational and
Results
Over the study period, 124 consecutive patients received hypofractionated PMRT after implant-based IBR. Among them, 10 were excluded (prior thoracic RT, local relapse), leaving 114 available for the analysis: 69 patients in the irradiated TE/I-group and 45 patients in the irradiated DTI-group. All patients completed PMRT (baseline characteristics are summarized in Table 1S). The two groups of irradiated patients (both DTI and TE/I) were well balanced with no significant differences, except the
Discussion
The study focused on the reconstructive outcome of patients with implant-based IBR who received PMRT compared to non-irradiated matched controls.
Although it is well known that autologous reconstruction is associated with better outcomes than implants in the RT setting [24], [25], [26], the rapid expansion of the use of skin and nipple-sparing mastectomies has resulted in a growing number of breast cancer patients with implant-based IBR, fueling the debate over the timing and sequence of PMRT
Declaration of Competing Interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgements
This work was partially supported by the Italian Ministry of Health with Ricerca Corrente and 5x1000 funds.
The author Damaris Patricia Rojas, M.D., was supported in part by research grants from the Fondazione IEO-CCM and Fondazione Veronesi.
Mattia Zaffaroni had research grant from Accuray Inc. (Data collection and analysis of Tomotherapy and CyberKnife breast clinical studies, breast physics studies and prostate study).The funders had no role in study design, data collection and analysis,
Ethics approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Availability of data and material
The authors confirm that the data supporting the findings of this study are available within the article.
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Cited by (3)
Moderately hypofractionated post-operative radiation therapy for breast cancer: Systematic review and meta-analysis of randomized clinical trials
2022, BreastCitation Excerpt :This includes regional nodal irradiation and treatment after mastectomy, with or without breast reconstruction [33,34]. Recent data from European Institute of Oncology demonstrated that the use of moderately hypofractionated irradiation to implant-based immediate breast reconstruction did not appear to increase the risk of reconstruction failure [35]. This concept is in line with the 2021 St Gallen consensus conference, where the majority of breast cancer experts (63.64%) recommend that moderately hypofractionated irradiation schedules can be used without restriction after immediate reconstruction even though none of the available clinical trials specifically included these patients [36].
Breast Reconstruction Strategies in Case of Planned Radiotherapy
2022, Handchirurgie Mikrochirurgie Plastische Chirurgie