Minireviews
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. May 28, 2020; 12(5): 68-75
Published online May 28, 2020. doi: 10.4329/wjr.v12.i5.68
Adaptive radiation therapy of breast cancer by repeated imaging during irradiation
Omer Sager, Ferrat Dincoglan, Selcuk Demiral, Bora Uysal, Hakan Gamsiz, Fatih Ozcan, Onurhan Colak, Yelda Elcim, Esin Gundem, Bahar Dirican, Murat Beyzadeoglu
Omer Sager, Ferrat Dincoglan, Selcuk Demiral, Bora Uysal, Hakan Gamsiz, Fatih Ozcan, Onurhan Colak, Yelda Elcim, Esin Gundem, Bahar Dirican, Murat Beyzadeoglu, Department of Radiation Oncology, Gulhane Medical Faculty, University of Health Sciences, Etlik, Ankara 06018, Turkey
Author contributions: Sager O, Dincoglan F, Demiral S, Uysal B, Gamsiz H, Ozcan F and Colak O played significant role in data acquisition, interpretation of data, reviewing and writing of the manuscript; Elcim Y, Gundem E and Dirican B worked on checking the manuscript for important intellectual content; Beyzadeoglu M took part in designing, reviewing and writing of the manuscript and checking the manuscript for important intellectual content; all authors read and approved the final version of the manuscript.
Conflict-of-interest statement: No conflicts to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Omer Sager, MD, Associate Professor, Department of Radiation Oncology, Gulhane Medical Faculty, University of Health Sciences, Etlik, Ankara 06018, Turkey. omersager@gmail.com
Received: February 28, 2020
Peer-review started: February 28, 2020
First decision: April 25, 2020
Revised: May 8, 2020
Accepted: May 16, 2020
Article in press: May 16, 2020
Published online: May 28, 2020
Processing time: 89 Days and 1.8 Hours
Abstract

Breast cancer is the most frequent cancer among females and also a leading cause of cancer related mortality worldwide. A multimodality treatment approach may be utilized for optimal management of patients with combinations of surgery, radiation therapy (RT) and systemic treatment. RT composes an integral part of breast conserving treatment, and is typically used after breast conserving surgery to improve local control. Recent years have witnessed significant improvements in the discipline of radiation oncology which allow for more focused and precise treatment delivery. Adaptive radiation therapy (ART) is among the most important RT techniques which may be utilized for redesigning of treatment plans to account for dynamic changes in tumor size and anatomy during the course of irradiation. In the context of breast cancer, ART may serve as an excellent tool for patients receiving breast irradiation followed by a sequential boost to the tumor bed. Primary benefits of ART include more precise boost localization and potential for improved normal tissue sparing with adapted boost target volumes particularly in the setting of seroma reduction during the course of irradiation. Herein, we provide a concise review of ART for breast cancer in light of the literature.

Keywords: Breast cancer; Adaptive radiation therapy; Tumor bed boost; Computed tomography; Imaging; Replanning

Core tip: Adaptive radiation therapy (ART) refers to redesigning of treatment plans with respect to dynamic changes in tumor size and anatomy during the course of irradiation. There have been several applications of ART for a variety of cancers. In the context of breast cancer, ART may serve as an excellent tool for patients receiving breast irradiation followed by a sequential boost to the tumor bed. Primary benefits of ART include more precise boost localization and potential for improved normal tissue sparing with adapted boost target volumes particularly in the setting of seroma reduction during the course of irradiation.