Elective breast radiotherapy including level I and II lymph nodes: A planning study with the humeral head as planning risk volume
نویسندگان
چکیده
BACKGROUND The aim of this study was to assess the dose to the humeral head planning risk volume with the currently used high tangential fields (HTF) and compare different planning techniques for breast radiotherapy including axillary level I and II lymph nodes (PTVn) while sparing the humeral head. METHODS Ten patients with left-sided breast cancer were enrolled in a planning study with 16 fractions of 2.66 Gy. Four planning techniques were compared: HTF, HTF with sparing of the humeral head, 6-field IMRT with sparing of the humeral head and VMAT with sparing of the humeral head. The humeral head + 10 mm was spared by restricting V40Gy < 1 cc. RESULTS The dose to the humeral head was too high with HTF (V40Gy on average 20.7 cc). When sparing the humeral head in HTF, PTVn V90% decreased significantly from 97.9% to 89.4%. 6-field IMRT and VMAT had a PTVn V90% of 98.2% and 99.5% respectively. However, dose to the lungs, heart and especially the contralateral breast increased with VMAT. CONCLUSIONS The humeral head is rarely spared when using HTF. When sparing the humeral head, the 6-field IMRT technique leads to adequate PTV coverage while not increasing the dose to the OARs.
منابع مشابه
Comparing different techniques of Post Axillary field in Breast Cancer Treatment
As we know breast cancer is the second death reason in Iran. One step of treatment process is radiotherapy, which needs careful consideration of contouring and therapeutic techniques Lung, thyroid, spinal cord, trachea and humerus are sensitive organs in breast cancer radiation therapy. The most clinical studies recommended two ways for delivering 95 percent of dose to supraclavicular and ...
متن کاملStandardization of whole breast radiotherapy is required for safe omission of axillary lymph node dissection in breast cancer patients
Background: The purpose of this study was to assess the dose distribution and coverage of level Ⅰ-Ⅱ axillary lymph nodes during whole breast tangential field radiotherapy (RT) after breast-conserving surgery in patients with breast cancer. Materials and Methods: The level Ⅰ-Ⅱ axillary lymph node volumes were retrospectively contoured by a single radiation oncologist based on computed tomography...
متن کاملAxillary irradiation in breast cancer; does meticulous contouring make a difference?
Background: Due to the current trends towards replacing axillary dissection with radiotherapy, the need for more precise definition for different nodal stations becomes a must to ensure safe and adequate dose coverage. So, our study aimed to evaluate the coverage of axillary nodal volumes based on Project on Cancer of the Breast (PROCAB) guidelines, for cases previously treated with our standar...
متن کاملIntensity modulated radiotherapy with fixed collimator jaws for locoregional left-sided breast cancer irradiation
The purpose of this study is to evaluate the intensity modulated radiotherapy (IMRT) with the fixed collimator jaws technique (FJT) for the left breast and regional lymph node. The targeted breast tissue and the lymph nodes, and the normal tissues were contoured for 16 left-sided breast cancer patients previously treated with radiotherapy after lumpectomy. For each patient, treatment plans usin...
متن کاملEvaluation of regional nodes irradiation during breast cancer radiotherapy
Background: The purpose of this study was to evaluate nodal irradiation with conventional three-field's technique. Materials and Methods: Fifty patients with breast cancer were enrolled in this study. Computed tomography scans in the supine treatment position were imported into a treatment planning system. Levels I-III axillary and supraclavicular nodes were identified and their depths to the a...
متن کامل