TOMO Technology Empowerment! Patients with bilateral breast cancer are reborn

Precision radiotherapy techniques for tomoTherapy.

Red Net Moment February 8 (correspondent Peng Lu Guo Geyang) "Doctor, both sides of my breast have to do radiotherapy, is there any hope?" Recently, Ms. Yang, a 39-year-old patient from Liuyang, was anxious to ask Professor Hu Ying, deputy director of the Second Department of Chest Radiotherapy of Hunan Provincial Cancer Hospital. It is understood that Ms. Yang is a bilateral breast invasive carcinoma patient, with multiple lymph node metastases in bilateral axillaries, and after surgery, there is a local metastasis of the tumor sternum, which is very critical, fortunately, with the help of the popularization and development of new technologies such as spiral tomography and radiation therapy (TomoTherapy) in Hunan Provincial Cancer Hospital, many patients like Ms. Yang have found hope again.

According to statistics, in 2020, among the world's female cancer patients, breast cancer surpassed lung cancer to become the world's largest cancer, and the mortality rate ranked fifth, of which about 0.7 to 3.0% of patients had simultaneous bilateral breast cancer. According to the statistics and recommendations of previous clinical studies and guidelines, radiotherapy can reduce the risk of local recurrence by about 70%, and the 5-year recurrence rate will also drop to less than 5%.

The traditional mode of radiation therapy for breast cancer uses two-dimensional tangent field irradiation or conventional adaptive intensity-modulated radiotherapy, which can basically meet the dose distribution requirements for the treatment of unilateral breast cancer. However, for simultaneous bilateral breast cancer, because of its large target range, how to give the required target area sufficient therapeutic dose under the premise of protecting normal tissues has always been a difficult point for postoperative radiation therapy of breast cancer.

"Ms. Yang not only has to irradiate both chest walls and lymphatic drainage areas at the same time, but also gives a simultaneous push of the sternal metastases, which is more than 20% higher than the general postoperative radiation dose, and at the same time ensures that the irradiation of the heart and lungs immediately after them is within the normal tolerance of Fan Wei, so it is much more difficult than conventional postoperative radiation therapy for bilateral breast cancer." Professor Hu Ying, deputy director of the second department of chest radiotherapy of the hospital, said.

Therefore, Professor Hu Ying led Guo Geyang, deputy chief physician, Wang Yong and other team members, on the basis of fully assessing Ms. Yang's expected survival, lymph node metastasis, the scope of sternal metastases, the shape and volume of normal organs such as the heart and lungs, accurately designed the irradiation target area for her, and gave her the appropriate postoperative radiotherapy dose and additional dose of sternal metastases, while the normal organs such as double lungs, heart, and spinal cord were strictly limited according to the standard and controlled within a safe range. Through communication and cooperation with physicists and radiotherapy technicians, using advanced TOMO technology, the final design of a radiation therapy plan with a uniform dose and a high degree of consistency with the irradiation target area, such as a scalpel.

In the end, Ms. Yang successfully completed 28 times of radiotherapy, the efficacy was satisfactory, no obvious radiation skin mucosal reaction, radiation pneumonia and other acute radiation injuries occurred, and her condition was stable, and the long-term efficacy was under further observation.