T
RATAMENTO
COM
RADIOTERAPIA
DE
INTENSIDADE
MODULADA
(IMRT)
PARA
CÂNCER
DE
MAMA
R
EV
A
SSOC
M
ED
B
RAS
2014; 60(6):508-511
511
R
EFERÊNCIAS
1. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA
Cancer J Clin 2005; 55:74.
2. Brasil. Ministério da Saúde. Estimativas para o ano de 2012 de número de
casos novos e de óbitos por câncer emmulheres, segundo localização primária.
Disponível em:
www.inca.gov.br/estimativa/2012/index.asp?ID=5.Acessado
em: 22/7/2013.
3. Barnett GC, Wilkinson J, Moody AM, Wilson CB, Sharma R, Klager S, et al.
A randomised controlled trial of forward-planned radiotherapy (IMRT) for
early breast cancer: baseline characteristics and dosimetry results. Radiother
Oncol. 2009;92:34-41.
4. Donovan E, Bleakley N, Denholm E, Evans P, Gothard L, Hanson J, et al.
Randomised trial of standard 2D radiotherapy (RT)
versus
intensity modulated
radiotherapy (IMRT) in patients prescribed breast radiotherapy. Radiother
Oncol. 2007;82:254-64.
5. Burmeister J, Way S, McDermott P, Bossenberger T, Jaenisch H, Patel R, et
al. Assessment and minimization of contralateral breast dose for conventional
and intensity modulated breastradiotherapy. Med Dosim. 2008;33:6-13.
6. Bhatnagar AK, Brandner E, Sonnik D, Wu A, Kalnicki S, Deutsch M, et al.
Intensity modulated radiation therapy (IMRT) reduces the dose to the
contralateral breastwhen compared to conventional tangential ields for
primary breast irradiation. Breast Cancer Res Treat. 2006;96:41-6.
7. Landau D, Adams EJ, Webb S, Ross G. Cardiac avoidance in breast
radiotherapy: a comparison of simple shielding techniques with intensity-
modulated radiotherapy. Radiother Oncol. 2001;60:247-55.
8. Johansen S, Cozzi L, Olsen DR. A planning comparison of dose patterns in
organs at risk and predicted risk for radiation induced malignancy in the
contralateral breast following radiation therapy of primary breast using
conventional, IMRT and volumetric modulated arc treatment techniques.
Acta Oncol. 2009;48:495-503.
9. Stillie AL, Kron T, Herschtal A, Hornby C, Cramb J, Sullivan K, et al. Does
inverse-planned intensity-modulated radiation therapy have a role in the
treatment of patients with left-sided breast cancer? J Med Imaging Radiat
Oncol. 2011;55:311-9.
10. Ercan T, I dem S, Alço G, Zengin F, Atilla S, Dinçer M, et al. Dosimetric
comparison of ield in ield intensity-modulated radiotherapy technique
with conformal radiotherapy techniques in breast cancer. Jpn J Radiol.
2010;28:283-9.
11. Fong A, Bromley R, Beat M, Vien D, Dineley J, Morgan G. Dosimetric
comparison of intensity modulated radiotherapy techniques and standard
wedged tangents for whole breast radiotherapy. J Med Imaging Radiat Oncol.
2009;53:92-9.
12. Schubert LK, Gondi V, Sengbusch E, Westerly DC, Soisson ET, Paliwal BR,
et al. Dosimetric comparison of leftsided whole breast irradiation with
3DCRT, forward-planned IMRT, inverse-plannedIMRT, helical tomotherapy,
and topotherapy. Radiother Oncol. 2011;100:241-6.
13. Baycan D, Karacetin D, Balkanay AY, Barut Y. Field-in-ield IMRT versus
3D-CRT of the breast. Cardiac vessels, ipsilateral lung, and contralateral
breast absorbed doses in patients with left-sided lumpectomy: a dosimetric
comparison. Jpn J Radiol. 2012;30:819-23.
14. Coon AB, Dickler A, Kirk MC, Liao Y, Shah AP, Strauss JB, et al. Tomotherapy
and multiield intensity-modulated radiotherapy planning reduce cardiac
doses in left-sided breast cancer patients with unfavorable cardiac anatomy.
Int J Radiat Oncol Biol Phys. 2010;78:104-10.
15. Rudat V, Alaradi AA, Mohamed A, Ai-Yahya K, Altuwaijri S. Tangential beam
IMRT versus tangential beam 3D-CRT of the chest wall in postmastectomy
breast cancer patients: a dosimetric comparison. Radiat Oncol. 2011;6:26.
16. Pignol JP, Olivotto I, Rakovitch E, Gardner S, Sixel K, Beckham W, et al. A
multicenter randomized trial of breast intensity-modulated radiation therapy
to reduce acute radiation dermatitis. J Clin Oncol. 2008;26:2085-92.
17. Mukesh MB, Barnett GC, Wilkinson JS, Moody AM, Wilson C, Dorling L,
et al. Randomized controlled trial of intensity-modulated radiotherapy for
early breast cancer: 5-year results conirm superior overall cosmesis. J Clin
Oncol. 2013 Sep 16. [Epub ahead of print]
18. McDonald MW, Godette KD, Butker EK, Davis LW, Johnstone PAS. Long-
term outcomes of IMRT for breast cancer: a single-institution cohort analysis.
Int J Radiat Oncol Biol Phys. 2008;72:1031-40.
19. Harsolia A, Kestin L, Grills I, Wallace M, Jolly S, Jones C, et al. Intensity-
modulated radiotherapy results in signiicant decrease in clinical toxicities
compared with conventional wedge-based breast radiotherapy. Int J Radiat
Oncol Biol Phys. 2007;68:1375-80.
Recomendação
Quando comparada com as técnicas de radioterapia con-
vencional ou conformada da mama, a IMRT apresenta
benefícios dosimétricos, de toxicidade e de qualidade de
vida, não prejudicando o controle local e a sobrevida glo-
bal das pacientes.
A
PÊNDICE
1
Estratégia de busca Medline
(Breast Neoplasms [Mesh] OR Breast Neoplasm OR Neo-
plasm, Breast OR Neoplasms, Breast OR Tumors, Breast
OR Breast Tumors OR Breast Tumor OR Tumor, Breast
OR Mammary Carcinoma, Human OR Carcinoma, Hu-
man Mammary OR Carcinomas, Human Mammary OR
Human Mammary Carcinomas OR Mammary Carcino-
mas, Human OR Human Mammary Carcinoma ORMam-
mary Neoplasms, Human OR Human Mammary Neo-
plasm OR Human Mammary Neoplasms OR Neoplasm,
HumanMammary OR Neoplasms, HumanMammary OR
Mammary Neoplasm, Human OR Breast Cancer OR Can-
cer, Breast OR Cancer of the Breast OR Cancer of Breast)
AND (Radiotherapy, Intensity-Modulated [Mesh] OR In-
tensity-Modulated Radiotherapies OR Intensity-Modula-
ted Radiotherapy OR Radiotherapies, Intensity-Modula-
ted OR Radiotherapy, Intensity Modulated OR IMRT OR
Volumetric-Modulated Arc Therapy OR Arc Therapies, Vo-
lumetric-Modulated OR Arc Therapy, Volumetric-Modu-
lated OR Therapies, Volumetric-Modulated Arc OR The-
rapy, Volumetric-Modulated Arc OR Volumetric Modulated
Arc Therapy OR Volumetric-Modulated Arc Therapies OR
Intensity-Modulated Arc Therapy OR Arc Therapies, In-
tensity-Modulated OR Arc Therapy, Intensity-Modulated
OR Intensity Modulated Arc Therapy OR Intensity-Mo-
dulated Arc Therapies OR Therapies, Intensity-Modula-
ted Arc OR Therapy, Intensity-Modulated Arc OR Helical
Tomotherapy OR Helical Tomotherapies OR Tomothera-
pies, Helical OR Tomotherapy, Helical) AND (Radiothe-
rapy, Conformal [Mesh] OR Conformal Radiotherapies
OR Radiotherapies, Conformal OR Conformal Radiothe-
rapy OR Radiotherapy Planning, Computer-Assisted OR
Radiotherapy Dosage OR Radiotherapy Planning, Com-
puter-Assisted OR “3D radiotherapy” OR “tridimensio-
nal radiotherapy” OR “3D RT” OR “3DRT” OR “3DCRT”
OR “CRT” OR “3D-CRT”) OR (Conventional radiothe-
rapy OR “2D radiotherapy” OR “2D RT” OR “2DRT” OR
“2D-CRT OR “standard radiotherapy” OR “two-dimensio-
nal radiotherapy”).
Outras diretrizes em
www.projetodiretrizes.org.br