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Recommendations for hypofractionated whole-breast irradiation

SUMMARY This recommendation consensus for hypofractionated whole-breast radiotherapy (RT) was organized by the Brazilian Society of Radiotherapy (SBRT) considering the optimal scenario for indication and safety in the technology applied. All controversies and contraindication matters (hypofractionat...

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Published in:Revista da Associação Médica Brasileira (1992) 2018-09, Vol.64 (9), p.770-777
Main Authors: Freitas, Nilceana Maya Aires, Rosa, Arthur Accioly, Marta, Gustavo Nader, Hanna, Samir Abdalla, Hanriot, Rodrigo de Morais, Borges, Allisson Bruno Barcelos, Gondim, Guilherme Rocha Melo, Pellizzon, Antonio Cassio Assis, Veras, Igor Moreira, Almeida Júnior, Wilson José de, Fernandez, Claudia Regina Scaramello Hadlich Willis, Batalha Filho, Eronides Salustiano, Castilho, Marcus Simões, Kuhnen, Felipe Quintino, Najas, Rosa Maria Xavier Faria, Affonso Júnior, Renato José, Leite, André Campana Correia, Ribeiro, Homero Lavieri Martins, Freitas Junior, Ruffo, Oliveira, Harley Francisco de
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Language:English
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Summary:SUMMARY This recommendation consensus for hypofractionated whole-breast radiotherapy (RT) was organized by the Brazilian Society of Radiotherapy (SBRT) considering the optimal scenario for indication and safety in the technology applied. All controversies and contraindication matters (hypofractionated RT in patients who underwent chemotherapy [CT], hypofractionated RT in lymphatic drainage, hypofractionated RT after mastectomy with or without immediate reconstruction, boost during surgery, hypofractionated RT in patients under 50 years old, hypofractionated RT in large breasts, hypofractionated RT in histology of carcinoma in situ [DCIS]) was discussed during a meeting in person, and a consensus was reached when there was an agreement of at least 75% among panel members. The grade for recommendation was also suggested according to the level of scientific evidence available, qualified as weak, medium, or strong. Thus, this consensus will aid Brazilian radiotherapy experts regarding indications and particularities of this technique as a viable and safe alternative for the national reality. RESUMO Este consenso de recomendações para a radioterapia (RT) hipofracionada de toda a mama foi organizado pela Sociedade Brasileira de Radioterapia (SBRT) considerando o cenário ideal para indicação e segurança na tecnologia aplicada. Questões de controvérsias e contraindicações (RT hipofracionada em pacientes submetidas à quimioterapia [QT], RT hipofracionada nas drenagens linfáticas, RT hipofracionada após mastectomia com ou sem reconstrução imediata, a realização de reforço de dose em leito cirúrgico [ou boost], RT hipofracionada em pacientes com idade menor que 50 anos, RT hipofracionada em mamas volumosas, RT hipofracionada em histologia de carcinoma in situ [CDIS]) foram discutidas em encontro presencial, sendo o consenso atingido quando existisse concordância de pelo menos 75% dos panelistas. O grau de recomendação foi também sugerido de acordo com o nível de evidência científico disponível, qualificado entre fraco, médio ou forte. Assim, este consenso deverá servir para auxiliar os especialistas da radioterapia brasileira em relação às indicações e particularidades dessa técnica, como uma alternativa segura e viável para a realidade nacional.
ISSN:0104-4230
1806-9282
DOI:10.1590/1806-9282.64.09.770