Abstract
Introduction
To evaluate the dosimetric data, early toxicity, and patient-reported cosmetic outcomes
in breast cancer patients treated with adjuvant proton-based radiotherapy (RT) after
breast-conserving surgery.
Materials and Methods
We performed a retrospective review of our institutional database to identify breast
cancer patients treated with breast-conserving surgery followed by proton-based RT
from 2015 to 2020. Patient-reported cosmetic outcomes were graded as excellent, good,
fair, or poor. Early toxicity outcomes were graded by the treating physician during
treatment. Dose-volume histograms were reviewed to obtain dosimetry data.
Results
We identified 21 patients treated with adjuvant proton-based RT. Median whole breast
dose delivered was 46.8 Gy (range, 40.0-50.4 Gy). Target volumes included the regional
lymph nodes in 17 patients (81%). Seventeen patients (81%) received a lumpectomy boost.
The median planning target volume V95 was 94% (range, 77%-100%), V100 71% (range,
60%-97%), V110 2% (range 0%-18%), and median max point dose was 115% (range, 105%-120%).
The median ipsilateral breast V105 was 367.3 cc (range, 0-1172 cc) and V110 was 24.1
cc (range, 0-321.3 cc). Grade 2 and 3 dermatitis occurred in 62% and 14% of patients,
respectively. Grade 2 and 3 pain was reported by 33% and 10% of patients, respectively.
Median follow-up at the time of cosmetic evaluation was 27 months (range, 5-42 months).
Four patients (21%) reported fair cosmetic outcome and 15 patients (79%) reported
good or excellent cosmetic outcome. No poor cosmesis was reported.
Conclusion
Adjuvant proton-based radiotherapy after breast-conserving surgery is well tolerated
with acceptable rates of acute toxicities and a high rate of good-to-excellent patient-reported
cosmetic outcomes.
Keywords
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Article info
Publication history
Published online: November 30, 2022
Accepted:
November 26,
2022
Received in revised form:
November 22,
2022
Received:
June 6,
2022
Identification
Copyright
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