{"id":4336,"date":"2017-02-10T11:56:59","date_gmt":"2017-02-10T11:56:59","guid":{"rendered":"http:\/\/www.library.sath.nhs.uk\/research\/?p=4336"},"modified":"2017-02-22T15:55:19","modified_gmt":"2017-02-22T15:55:19","slug":"thyroid-tolerance-in-adjuvant-supraclavicular-fossa-nodalradiotherapy-in-breast-cancer-2016","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2017\/02\/10\/thyroid-tolerance-in-adjuvant-supraclavicular-fossa-nodalradiotherapy-in-breast-cancer-2016\/","title":{"rendered":"Thyroid tolerance in adjuvant supraclavicular fossa nodalradiotherapy in breast cancer (2016)"},"content":{"rendered":"

Type of publication:<\/strong>
\nConference abstract<\/p>\n

Author(s):<\/strong>
\n*Pettit L., *Welsh A., *Khanduri S.<\/p>\n

Citation:<\/strong>
\nRadiotherapy and Oncology, April 2016, vol.\/is. 119\/(S558)<\/p>\n

Abstract:<\/strong>
\nPurpose or Objective: Hypothyroidism is the most commonly reported long-term toxicity following radiotherapy to structures near to the thyroid gland. Emami suggested the thyroid gland tolerance as 45Gy (TD 5\/5) although a much wider range of 10-80 Gy has been reported in the literature. When irradiating the supraclavicular fossa (SCF) in adjuvant radiotherapy for breast cancer, it is inevitable that the thyroid gland will receive a high dose of radiation due to its proximity to the target volume. Recently there has been a move to CT based delineation of the CTV and organs at risk (OAR) in patients requiring nodal radiotherapy for breast cancer compared with the previous bony land mark\/field based techniques. Dose received by the thyroid gland and subsequent late toxicity has not yet been well studied in breast cancer. Material and Methods: Patients undergoing external beam radiotherapy to the breast or chest wall plus SCF between 01\/04\/15-01\/10\/15 were identified. Radiotherapy planning contrast enhanced CT scans were taken. External beam radiotherapy was planned with tangents using a field in field approach with a matched direct anterior field. A low weighted posterior field was added if deemed appropriate for adequate dose coverage. Angle corrections were used as appropriate. A dose of 40.05 Gy in 15 fractions prescribed at depth was employed. CTV's were contoured in accordance with the RTOG contouring atlas. The thyroid gland was prospectively delineated and D5% was recorded. Results: Seventeen patients undergoing adjuvant SCF radiotherapy were identified. T stage was as follows: T1:2 patients, T2:9 patients, T3:4 patients, T4a:1 patient,T4d:1 patient. N stage; N1:1 patient, N2:14 patients, N3:2 patients. Fourteen were hormone receptor positive, 3 hormone negative. Twelve were HER2 negative, 5 HER2 positive. Mean D5% thyroid was 37.9Gy (range 7-42.7 Gy). Excluding one patient with a previous hemi-thyroidectomy, the mean D5% thyroid was 39.8 Gy (range 16-42.7 Gy). An abnormality requiring referral to a surgeon for was discovered in one patient. Conclusion: Our departmental tolerance for the thyroid gland was set as 40Gy (for 2.67Gy per fraction). It is hard to achieve this without compromise of the CTV. The effect modern chemotherapy\/targeted agents may have on this prior to receiving radiotherapy is inknown. Baseline TSH recording is desirable. Long-term follow up to detect clinical or biochemical thyroid dysfunction is needed to inform practice but would present challenges with capacity in busy oncology departments.<\/p>\n

Link to more details or full-text: https:\/\/user-swndwmf.cld.bz\/ESTRO-35\/ESTRO-35-Abstract-book3\/585<\/a><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

Type of publication: Conference abstract Author(s): *Pettit L., *Welsh A., *Khanduri S. Citation: Radiotherapy and Oncology, April 2016, vol.\/is. 119\/(S558) Abstract: Purpose or Objective: Hypothyroidism is the most commonly reported long-term toxicity following radiotherapy to structures near to the thyroid…<\/span><\/p>\n

Read more Thyroid tolerance in adjuvant supraclavicular fossa nodalradiotherapy in breast cancer (2016)<\/span> ›<\/span><\/a><\/div>\n

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