The use of bolus in postmastectomy radiation therapy for breast cancer: A systematic review

Dahn HM, Boersma LJ, de Ruysscher D, Meattini I, Offersen BV, Pignol JP, Aristei C, Belkacemi Y, Benjamin D, Bese N, Coles CE, Franco P, Ho A, Hol S, Jagsi R, Kirby AM, Marrazzo L, Marta GN, Moran MS, Nichol AM, Nissen HD, Strnad V, Zissiadis YE, Poortmans P, Kaidar-Person O (2021)

Publication Type: Journal article, Review article

Publication year: 2021

Journal

Book Volume: 163

Article Number: 103391

DOI: 10.1016/j.critrevonc.2021.103391

Abstract

Purpose: Post mastectomy radiation therapy (PMRT) reduces locoregional recurrence (LRR) and breast cancer mortality for selected patients. Bolus overcomes the skin-sparing effect of external-beam radiotherapy, ensuring adequate dose to superficial regions at risk of local recurrence (LR). This systematic review summarizes the current evidence regarding the impact of bolus on LR and acute toxicity in the setting of PMRT. Results: 27 studies were included. The use of bolus led to higher rates of acute grade 3 radiation dermatitis (pooled rates of 9.6% with bolus vs. 1.2% without). Pooled crude LR rates from thirteen studies (n = 3756) were similar with (3.5%) and without (3.6%) bolus. Conclusions: Bolus may be indicated in cases with a high risk of LR in the skin, but seems not to be necessary for all patients. Further work is needed to define the role of bolus in PMRT.

Involved external institutions

Dalhousie University Canada (CA) Maastricht University Netherlands (NL) Careggi University Hospital / Azienda Ospedaliero Universitaria Careggi Italy (IT) Aarhus University Hospital / Aarhus Universitetshospital Denmark (DK) Università degli Studi di Perugia Italy (IT) Centre hospitalier universitaire Henri-Mondor (CHU Henri-Mondor) France (FR) Chaim Sheba Medical Center at Tel HaShomer / המרכז הרפואי עש חיים שיבא – תל השומר‎‎ Israel (IL) Acibadem Maslak Hospital / Acıbadem Maslak Hospital Turkey (TR) University of Cambridge United Kingdom (GB) University of Eastern Piedmont / Università degli Studi del Piemonte Orientale "Amedeo Avogadro" Italy (IT) Massachusetts General Hospital United States (USA) (US) Dr. Bernard Verbeeten Instituut Netherlands (NL) University of Michigan United States (USA) (US) Royal Marsden Hospital / The Royal Marsden NHS Foundation Trust United Kingdom (GB) Hospital Sírio-Libanês Brazil (BR) Yale School of Medicine United States (USA) (US) British Columbia Cancer Agency Canada (CA) Vejle Sygehus Denmark (DK) Radiology Associates of Hollywood United States (USA) (US) University of Antwerp / Universiteit Antwerpen Belgium (BE)

How to cite

APA:

Dahn, H.M., Boersma, L.J., de Ruysscher, D., Meattini, I., Offersen, B.V., Pignol, J.P.,... Kaidar-Person, O. (2021). The use of bolus in postmastectomy radiation therapy for breast cancer: A systematic review. Critical Reviews in Oncology Hematology, 163. https://doi.org/10.1016/j.critrevonc.2021.103391

MLA:

Dahn, Hannah M., et al. "The use of bolus in postmastectomy radiation therapy for breast cancer: A systematic review." Critical Reviews in Oncology Hematology 163 (2021).

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