SHERP

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

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Authors
Jeon, Seung Hyuck; Shin, Kyung Hwan; Park, So-Yeon; Kim, Jung-in; Park, Jong Min; Kim, Jin Ho; Chie, Eui Kyu; Wu, Hong-Gyun
Issue Date
2017-06-20
Publisher
BioMed Central
Citation
Radiation Oncology, 12(1):103
Keywords
Breast cancerPartial breast irradiationAdaptive radiotherapySeroma
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.
ISSN
1748-717X
Language
English
URI
https://doi.org/10.1186/s13014-017-0843-7

http://hdl.handle.net/10371/117766
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College of Medicine/School of Medicine (의과대학/대학원)Radiation Oncology (방사선종양학전공)Journal Papers (저널논문_방사선종양학전공)
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