Are there additional risks associated with PMRT for a patient with prior lympho-venous bypass surgery?

Based on FABREC, we do offer hypofractionation after reconstruction and focus on plan quality with dose homogeneity and very selective use of bolus.

RT CHARM will further clarify.

LV bypass helps to reduce lymphedema risk and we don’t change fractionation based on that.

Conroy, Cancer Network 2023

There are two studies I am aware of, specifically addressing the location of LV bypass in relation to different RT fields - Spiegel et al., PMID 37141983 and Naoum et al (abstract Astro 2022).

While we found that in both studies the bypass is usually located in level-1 & 2 mainly, there was no direct...