Advances in Mitigating Skin Toxicity in Whole Breast Radiotherapy for Breast Cancer: The Role of Field-in-Field Techniques

Whole breast radiotherapy (WBRT) constitutes a cornerstone of treatment for women with early-stage breast cancer who have undergone breast-conserving surgery (BCS). While WBRT significantly reduces the risk of locoregional recurrence and breast cancer-related mortality, its clinical utility is often overshadowed by the development of skin toxicities. These adverse effects can have a substantial impact on a patient's quality of life and treatment compliance.This comprehensive review article delves into the multifaceted challenges posed by skin toxicity in the context of WBRT and explores the cutting-edge strategies employed to mitigate these issues. The central focus of this discussion is the integration of field-in-field (FIF) techniques within the framework of three-dimensional conformal radiotherapy (۳D-CRT) treatment planning. These FIF techniques have rapidly gained prominence as the standard of care for WBRT due to their potential to optimize dose distribution while minimizing acute skin toxicity.Through a meticulous analysis of recent studies, clinical trials, and emerging technologies, this article provides a thorough examination of the pivotal role that FIF techniques play in skin toxicity management during WBRT for breast cancer. Additionally, it explores the mechanisms underlying the development of skin toxicities, risk factors, and patient-specific considerations that can influence their severity. By presenting a comprehensive overview of the latest advancements, this article equips clinicians, researchers, and healthcare providers with a deeper understanding of how to enhance the therapeutic benefits of WBRT while prioritizing patient's comfort and well-being. Ultimately, it aims to foster a more informed and effective approach to breast cancer radiotherapy, with an emphasis on reducing the burden of treatment-related skin toxicities.

کلیدواژه ها:

Skin Toxicity ، field-in-field radiotherapy ، Breast Cancer ، WBRT