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A post-mastectomy Radiation Therapy Dose Distribution Study

International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2017年第4期6卷 457-467页

作者： Xin Qian Kalpana Vaidya Lindsay Puckett Ferney Diaz Xiaoli Tang Lucille Lee Eric Klein Department of Radiation Medicine Northwell Health New York NY USA MSKCC New York NY USA

Purpose: For post-mastectomy radiation therapy, skin dose must be accurately estimated to assess skin reactions, such as: erythema, desquamation, and necrosis. Even with advanced algorithms, planning systems do not always provide accurate dosimetry for target volumes distal to skin. Methods and Materials: In this study, a female anthropomorphic (ART) phantom and the newest generation of optically stimulated luminescence dosimeters (OSLD) (nanoDots, Landauer Inc.) were deployed to measure chest wall dose distribution. Since actual dose to patients’ lung and heart cannot be measured using in-vivo dosimetry, film was also used to verify the dose distribution to the left lung and heart. The treatment planning was performed using tolerance limits of 95% to 107% of prescription dose. The ART phantom was irradiated according to 3 three-dimensional (3D) conformal radiotherapy plans for 200 cGy dose per fraction using 6 MV medial and lateral tangential photon beams. The dose distribution provided by treatment planning was studied using nanoDots and film. Results: Results show that the largest surface dose difference between nanoDots measurement and prescribed dose for medial and lateral tangential beams, are 3.8% and 9.8%, respectively. This difference may be due to higher effective point of measurement and angular dependence of the nanoDots. The maximum differences in measured dose compared with prescribed dose, using film for heart and the left lung, were 6.2% and 7.5% respectively. Conclusions: Both nanoDots and film provided reasonable estimation of dose distribution in post-mastectomy radiation therapy.

关键词： Breast Radiotherapy post-mastectomy Chest-Wall Surface Dose OSLD NanoDot

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Study on the Impact of post-mastectomy Radiotherapy on Immediate Breast Reconstruction and Complications: A Meta-Analysis

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Journal of Clinical and Nursing Research 2024年第6期8卷 64-76页

作者： Wen Li Manman Sun Lihao Zheng Yibo Jiang Nan Ba Department of Radiation Oncology Fifth Affiliated Hospital of Zhengzhou UniversityZhengzhou CityHenan Province 450000China

Background and objective:Immediate breast reconstruction not only reduces the number of surgeries for patients after mastectomy but also decreases psychological and physical trauma,making it increasingly ***,there is currently no consensus on the integration of post-mastectomy radiotherapy(PMRT)with reconstruction *** review evaluates the impact of PMRT on complications following immediate breast reconstruction,providing guidance for clinical treatment ***:PubMed,Web of Science,Embase,and other databases were searched for studies published in the past 15 years on outcomes of implant-based breast reconstruction in the context of radiotherapy to identify articles for *** 5.4 software was used to analyze the risks of seroma,infection,wound dehiscence,flap necrosis,implant exposure,capsule contracture,and reconstruction ***:A total of 1l relevant studies were included,comprising 6323 cases of immediate breast *** was found that breasts receiving postoperative irradiation had a significantly increased risk of complications,with statistically significant differences in seroma(P=0.004),infection(Ppostoperative radiotherapy significantly increases the risk of complications for patients undergoing immediate implant-based *** measures may be taken in advance with the assistance of healthcare providers if necessary.

关键词： Breast cancer Immediate breast reconstruction Radiotherapy post-mastectomy Complications

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Comparative Study between Lidocaine 2% and Dexamethasone Local Wound Infiltration Effect on postoperative Pain post mastectomy: A Randomized Controlled Study

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Advances in Breast Cancer Research 2018年第4期7卷 243-249页

作者： Hussein O. Soliman National Cancer Institute Cairo Egypt

Objective: To compare the efficacy and safety of Lidocaine 2% versus Dexamethasone injected locally in mastectomy wound as pain relieving agents. Materials & Methods: A randomized single-blinded study in which 50 patients candidate for mastectomy were included. Participants were equally randomized into two groups;Group A, in which patients received 10 ml Lidocaine 2% and Group B, in which patients received 16 mL Dexamethasone. In both groups, the drugs were given via local infiltration in the subcutaneous layer of the mastectomy wound immediately after skin closure. Pain control was assessed post-operatively in the first 24 hours using the visual analogue scale (VAS) in addition the need for additional analgesia was recorded. Results: There was a statistically significant lower VAS score in group A (Lidocaine group) when compared to those in group B (Dexamethasone group) 1 h, 6 h, 12 h postoperatively with no significance 24 h postoperatively (36% vs 64% 1 h, 28% vs 64% 6 h, 30% vs 72% 12 h and, 80% vs 60% 24 h). This statistical significance was evident throughout the post-operative hours (1 h, 6 h, 12 h). Though local Lidocaine caused marked improvement of pain in bigger number of patients in group A than group B, yet it showed no statistical significance 24 h post-mastectomy. Furthermore, the number of participants that needed additional doses of analgesia lower in group A (48% vs 56%) in comparison to group B, but still showed no statistical significance. Conclusion: Local injection of Lidocaine 2% in mastectomy wounds, has an upper hand in reducing the post-operative pain and showed a lesser need for post-operative analgesia when compared to local Dexamethasone injection.

关键词： post-mastectomy Pain Lidocaine Dexamethasone

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