How much can the risks of sequelae from radiotherapy for breast cancer be reduced?
Basso-Ricci, S.; Sverzellati, E.; Coopmans de Yoldi, G.F.
Panminerva Medica 27(4): 195-199
1985
ISSN/ISBN: 0031-0808 PMID: 3831863 Document Number: 252847
The possibility is examined that the appearance of new types of therapy, the most modern equipment for radiotherapy, and the use of new types of surgical interventions have contributed to reduce the sequelae of radiotherapy. High energies make it possible to spare superficial tissues, even if at the level of the axillary region one should take into account the superficiality of the build-up due to the position of the cutaneous surfaces in relation to the beam of radiation. The simulator makes is possible to avoid overlapping of fields, especially supraclavicular and axillary. Recourse to more limited surgeries, which permits conservation of the pectoral muscles, reduces the risk of edema of the superior limb. Chemotherapy renders useless recourse to radiotherapy of the axillary region, even when the excised lymph nodes are metastatic, thus reducing the incidence of lesions to the brachial plexus and of edema of the arm. The authors recommend avoiding irradiation of parts of the heart and liver, which in obese patients and with target-dose of 6000 rad are irradiated even during treatments with tangential fields up to doses of 2500 rad, by use of narrower fields and a simulator.