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Radiat Oncol. 2017 Jun 20;12(1):103. doi: 10.1186/s13014-017-0843-7.

Seroma change during magnetic resonance imaging-guided partial breast irradiation and its clinical implications.

Jeon SH1,2, Shin KH3,4,5,6, Park SY2,7,8, Kim JI2,7,8, Park JM2,7,8, Kim JH1,2,7,8, Chie EK1,2,7,8, Wu HG1,2,7,8.

Author information

1
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea.
2
Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea.
3
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea. radiat@snu.ac.kr.
4
Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea. radiat@snu.ac.kr.
5
Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea. radiat@snu.ac.kr.
6
Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea. radiat@snu.ac.kr.
7
Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
8
Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.

Abstract

BACKGROUND:

To investigate the patterns of post-lumpectomy seroma volume (SV) change and related clinical factors to determine the benefits of adaptive planning in magnetic resonance imaging (MRI)-guided partial breast irradiation (PBI).

METHODS:

MRI data obtained from 37 women with early breast cancer acquired at simulation and at the 1st, 6th, and 10th fractions were analyzed. The planning target volume (PTV) was defined as unequal margins of 10-15 mm added according to the directional surgical margin status of each seroma. Treatment was performed using a 0.35 T MRI-guided radiotherapy system. Univariate analysis was performed to assess the correlations between SV change rate and clinical factors. Seroma and PTV for adaptive planning were based on the images obtained at the 6th fraction.

RESULTS:

The average time intervals between surgery-simulation, simulation-1st, 1st-6th, and 6th-10th fractions were 23.1, 8.5, 7.2, and 5.9 days, respectively. Of the 37 patients, 33 exhibited decreased SV over the treatment period. The mean SV of these 33 patients decreased from 100% at simulation to 60, 48, and 40% at each MRI scan. In most cases (26/33), the logarithm of SV was inversely proportional to the elapsed time from surgery (R 2 > 0.90, Pearson's correlation test). The volume of spared normal tissue from adaptive radiotherapy was proportional to the absolute change in SV (R 2 = 0.89, Pearson's correlation test).

CONCLUSION:

Seromas exhibit exponential shrinkage over the course of PBI. In patients receiving PBI, frequent monitoring of SV could be helpful in decision-making regarding adaptive planning, especially those with a large seroma.

KEYWORDS:

Adaptive radiotherapy; Breast cancer; Partial breast irradiation; Seroma

PMID:
28633637
PMCID:
PMC5477744
DOI:
10.1186/s13014-017-0843-7
[Indexed for MEDLINE]
Free PMC Article

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