Sh. Hanks et al., The acute effects of postoperative radiation therapy on the transverse rectus abdominis myocutaneous flap used in immediate breast reconstruction, INT J RAD O, 47(5), 2000, pp. 1185-1190
Citations number
25
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Onconogenesis & Cancer Research
Journal title
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
Purpose: To analyze the acute effects of postoperative radiation therapy on
the transverse rectus abdominis myocutaneous (TRAM) flap reconstruction fo
llowing modified radical mastectomy for breast cancer.
Methods and Materials: Twenty-five consecutive patients were treated with p
ostoperative radiation therapy after TRAM flap reconstruction between 1985
and 1999, The radiation records for these patients were retrospectively rev
iewed. Information regarding treatment techniques, timing, and dose was obt
ained and correlated with the extent of erythema, desquamation, and the nee
d for treatment break.
Results: The median age was 48 years, The median dose of chest wall radiati
on was 5040 cGy, Additional boost doses were delivered in 13 patients. Twel
ve patients (48%) developed mild erythema in the treatment field during the
course of treatment and 13 patients (52%) developed moderate (40%) or bris
k (12%) erythema, Only 10 patients (40%) developed any kind of desquamation
; 5 patients (20%) developed dry desquamation and another 5 patients (20%)
developed moist desquamation, No patients required a break in the course of
treatment because of acute side effects. None of the parameters evaluated
(the use of chemotherapy prior to radiation, the interval between surgery a
nd radiation, smoking, prior incidence of fat necrosis, the use of bolus du
ring radiation, and the use of a boost) were predictive of an increased inc
idence of either the extent of erythema or the development of desquamation
in the treatment field.
Conclusion: Postmastectomy radiation for TRAM flap reconstruction is well t
olerated and is not associated with an increased incidence of acute side ef
fects, Radiation technique and the use of preradiation chemotherapy do not
appear to be correlated with an increased incidence of acute side effects,
(C) 2000 Elsevier Science Inc.