Dear Authors,
If you believe that your paper was mistakenly rejected by other leading journals and you do not agree with final decision, the editors of Reports of Practical Oncology and Radiotherapy offer new fast track review. You may submit your manuscript to Reports of Practical Oncology and Radiotherapy together with all prior peer-reviews obtained from the other journal and your rebuttal letter. We guarantee review based decision within 72 hours from the time we will receive your manuscript.

Fast track submission process: Please submit the manuscript with all reviews and rebuttal letter by email to Dr. Michal Masternak ( for fast review processing. To assure immediate attention the email title must to include: RPOR-fast track- Last Name First Name (of corresponding author).

Volume 25, Number 3, 2020

Acute toxicity outcomes and dosimetric implications from incidental irradiation of adjacent tissues in tangent field hypofractionated breast radiotherapy

Sara R. Alcorn, Lindsey Sloan, Todd R. McNutt, Susan F. Stinson, Fariba Asrari, Victoria J. Croog, Bethlehem Floreza, Arcelia Weaver, Jean L. Wright


Purpose Adjacent tissues-in-beam (TIB) may receive substantial incidental doses within standard tangent fields during hypofractioned whole breast irradiation (HF-WBI). To characterize the impact of dose to TIB, we analyzed dosimetric parameters of TIB and associated acute toxicity. Materials and Methods Plans prescribed to 40.5 Gy/15 fractions from 4/2016-1/2018 were evaluated. Structures of interest were contoured: (1) TIB: all tissues encompassed by plan 30% isodose lines, (2) breast, (3) non-breast TIB (nTIB): TIB minus contoured breast. Volumes of TIB, breast, and nTIB receiving 100%–107% of prescription dose (V100-V107) were calculated. Twelve patient- and physician-reported acute toxicities were prospectively collected weekly. Correlations between volumetric and dosimetric parameters were assessed. Uni- and multivariable logistic regressions evaluated toxicity grade changes as a function of TIB, breast, and nTIB V100-V107 (in cm3). Results We evaluated 137 plans. Breast volume was positively correlated with nTIB and nTIB V100 (rho = 0.52, rho = 0.30, respectively, both p < 0.001). V107 > 2 cm3 were noted in 14% of breast and 21% of nTIB volumes. On multivariable analyses, increasing breast and nTIB V100 significantly raised odds of grade 2+ dermatitis and burning/twinging pain, respectively; increasing nTIB V105 elevated odds of hyperpigmentation and burning pain; and increasing nTIB V107 raised odds of burning pain. Threshold volumes for >6-fold odds of developing burning pain were TIB V105 > 100 cm3 and V107 > 5 cm3. Conclusions For HF-WBI, doses to nTIB over the prescription predicted acute toxicities independent of breast doses. These data support inclusion of TIB as a region of interest in treatment planning and protocol design.

Signature: Rep Pract Oncol Radiother, 2020; 25(3) : 345-350

« back


Indexed in: EMBASE®, the Excerpta Medica database, the Elsevier BIOBASE (Current Awareness in Biological Sciences) and in the Index Copernicus.