Japanese Journal of Radiology

, Volume 36, Issue 6, pp 401–406 | Cite as

Evaluation of adaptive radiotherapy (ART) by use of replanning the tumor bed boost with repeated computed tomography (CT) simulation after whole breast irradiation (WBI) for breast cancer patients having clinically evident seroma

  • Omer Sager
  • Ferrat Dincoglan
  • Bora Uysal
  • Selcuk Demiral
  • Hakan Gamsiz
  • Yelda Elcim
  • Esin Gundem
  • Bahar Dirican
  • Murat Beyzadeoglu
Original Article



The aim of this study is to evaluate adaptive radiotherapy (ART) by use of replanning the tumor bed boost with repeated computed tomography (CT) simulation after whole breast irradiation (WBI) for breast cancer patients having clinically evident seroma.

Materials and methods

Forty-eight patients with clinically evident seroma at the time of planning CT simulation for WBI were included. Two RT treatment plannings were generated for each patient based on the initial CT simulation and tumor bed boost CT simulation to assess seroma and boost target volume (BTV) changes during WBI. Also, dosimetric impact of ART was analyzed by comparative evaluation of critical organ doses in both RT treatment plannings.


Median time interval between the two CT simulations was 35 days. Statistically significant reduction was detected in seroma volume and BTV during the conventionally fractionated WBI course along with statistically significant reduction in critical organ doses with ART (p < 0.0001).


Our data suggest significant benefit of ART by use of replanning the tumor bed boost with repeated CT simulation after WBI for patients with clinically evident seroma.


Breast cancer Seroma Adaptive radiotherapy (ART) Whole breast irradiation (WBI) Tumor bed boost 



Whole breast irradiation


Breast conserving surgery




Computed tomography


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study. The study was performed in compliance with the Declaration of Helsinki principles.


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Copyright information

© Japan Radiological Society 2018

Authors and Affiliations

  • Omer Sager
    • 1
  • Ferrat Dincoglan
    • 1
  • Bora Uysal
    • 1
  • Selcuk Demiral
    • 1
  • Hakan Gamsiz
    • 1
  • Yelda Elcim
    • 1
  • Esin Gundem
    • 1
  • Bahar Dirican
    • 1
  • Murat Beyzadeoglu
    • 1
  1. 1.Department of Radiation OncologyGulhane Medical Faculty, University of Health SciencesKeciorenTurkey

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