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Skin reaction is major problem during whole breast radiotherapy. To identify factors related to skin reactions during whole breast radiotherapy, various personal, clinical, and radiation dosimetric parameters were evaluated. From January 2012 to December 2013, a total of 125 patients who underwent breast conserving surgery and adjuvant whole breast irradiation were retrospectively reviewed. All patients had both whole breast irradiation and boost to the tumour bed. Skin reaction was measured on the first day of boost therapy based on photography of the radiation field and medical records. For each area of axilla and inferior fold, the intensity score of erythema (score 1 to 5) and extent (score 0 to 1) were summed. The relationship of various parameters to skin reaction was evaluated using chi-square and linear regression tests. The V100 (volume receiving 100% of prescribed radiation dose, p<0.001, both axilla and inferior fold) and age (p=0.039 for axilla and 0.026 for inferior fold) were significant parameters in multivariate analyses. The calculated axilla dose (p=0.003) and breast separation (p=0.036) were also risk factors for axilla and inferior fold, respectively. Young age and large V100 are significant factors for acute skin reaction that can be simply and cost-effectively measured. [ABSTRACT FROM AUTHOR]

Introduction Radiotherapy increases the morbidity of immediate breast reconstruction. To spare the flapped area without an adverse dose distribution of the target volume and organ at risks, various radiation techniques were assessed. Methods Twelve breasts undergoing skin-sparing mastectomy and immediate transverse rectus abdominis myocutaneous flap reconstruction were evaluated. After a delineation of whole breast, the doughnut-like breast target volume ( BTV) including the chest wall and skin and the subtracted central flapped volume ( FV) were defined. The opposed wedge tangential radiotherapy (3-dimensional conformal radiotherapy (3- D CRT) ), field-in-field radiotherapy ( FiF), inverse intensity-modulated radiotherapy ( iIMRT), volumetric modulated arc radiotherapy ( VMRT) and the mixture of FiF and iIMRT ( HYBRID) were tried. Total 50 Gy was prescribed to the BTV. The paired student t-tests were performed. Results The V47.5Gy of the BTV was improved in iIMRT and VMRT compared with 3- D CRT and FiF. The mean FV doses in iIMRT and VMRT were 76.7 ± 3.9% and 85.5 ± 4.0%, respectively. However the mean ipsilateral lung doses were aggravated by iIMRT and VMRT. In terms of HYBRID, the V47.5Gy for the BTV was 97.5 ± 0.7%. The mean FV dose was 89.4 ± 2.1%. While the mean FV dose in HYBRID was 13.7 ± 2.1% ( P < 0.001) lower than FiF, it was 12.8 ± 1.9% ( P < 0.001) higher than iIMRT. The mean ipsilateral lung dose in HYBRID was 2.8 ± 1.9% ( P < 0.001) worse than FiF, and 2.6 ± 1.8% ( P < 0.001) better than iIMRT. Conclusions The HYBRID could minimise the adverse dose distribution of lung and reduce 10% of the mean dose to the flapped area. For patients with adverse factors for the failure of breast reconstruction, the HYBRID could be considered. [ABSTRACT FROM AUTHOR]

Simple Summary: Multiple myeloma is a plasma cell cancer involving bone destruction and is considered an incurable disease despite significant improvements in therapeutic strategies. During myeloma progression, over 90% of patients develop a bone disease that causes patient injury and death. There are limited animal models available to demonstrate multiple myeloma bone disease (MMBD). The current study identifies and validates the newly developed MMBD models with uniformity of tumor burden and severe bone lesions. This model will help study the biology of MMBD and serve as a valuable tool for screening therapeutic candidates by monitoring their response to disease progression. Multiple myeloma (MM) is a plasma cell malignancy that causes an accumulation of terminally differentiated monoclonal plasma cells in the bone marrow, accompanied by multiple myeloma bone disease (MMBD). MM animal models have been developed and enable to interrogate the mechanism of MM tumorigenesis. However, these models demonstrate little or no evidence of MMBD. We try to establish the MMBD model with severe bone lesions and easily accessible MM progression. 1 × 106 luciferase-expressing 5TGM1 cells were injected into 8–12 week-old NOD SCID gamma mouse (NSG) and C57BL/KaLwRij mouse via the tail vein. Myeloma progression was assessed weekly via in vivo bioluminescence (BL) imaging using IVIS-200. The spine and femur/tibia were extracted and scanned by the micro-computer tomography for bone histo-morphometric analyses at the postmortem. The median survivals were 56 days in NSG while 44.5 days in C57BL/KaLwRij agreed with the BL imaging results. Histomorphic and DEXA analyses demonstrated that NSG mice have severe bone resorption that occurred at the lumbar spine but no significance at the femur compared to C57BL/KaLwRij mice. Based on these, we conclude that the systemic 5TGM1 injected NSG mouse slowly progresses myeloma and develops more severe MMBD than the C57BL/KaLwRij model. [ABSTRACT FROM AUTHOR]