Three-Dimensional Volumetric Analysis of Irradiated Lung With Adjuvant Breast Irradiation

Journal Article · Tue Dec 01 00:00:00 EST 2009 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.12.077· OSTI ID:21367535

Park, Eileen J.H. ^[1]; Liang, Shen ^[2]; Chung, Hans T ^[1]

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1. Department of Radiation Oncology, The Cancer Institute, National University Hospital (Singapore)
2. Biostatistics Unit, Yang Loo Ling School of Medicine, National University of Singapore (Singapore)

Purpose: To retrospectively evaluate the dose-volume histogram data of irradiated lung in adjuvant breast radiotherapy (ABR) using a three-dimensional computed tomography (3D-CT)-guided planning technique; and to investigate the relationship between lung dose-volume data and traditionally used two-dimensional (2D) parameters, as well as their correlation with the incidence of steroid-requiring radiation pneumonitis (SRRP). Methods and Materials: Patients beginning ABR between January 2005 and February 2006 were retrospectively reviewed. Patients included were women aged >=18 years with ductal carcinoma in situ or Stage I-III invasive carcinoma, who received radiotherapy using a 3D-CT technique to the breast or chest wall (two-field radiotherapy [2FRT]) with or without supraclavicular irradiation (three-field radiotherapy [3FRT]), to 50 Gy in 25 fractions. A 10-Gy tumor-bed boost was allowed. Lung dose-volume histogram parameters (V{sub 10}, V{sub 20}, V{sub 30}, V{sub 40}), 2D parameters (central lung depth [CLD], maximum lung depth [MLD], and lung length [LL]), and incidence of SRRP were reported. Results: A total of 89 patients met the inclusion criteria: 51 had 2FRT, and 38 had 3FRT. With 2FRT, mean ipsilateral V{sub 10}, V{sub 20}, V{sub 30}, V{sub 40} and CLD, MLD, LL were 20%, 14%, 11%, and 8% and 2.0 cm, 2.1 cm, and 14.6 cm, respectively, with strong correlation between CLD and ipsilateral V{sub 10-V40} (R{sup 2} = 0.73-0.83, p < 0.0005). With 3FRT, mean ipsilateral V{sub 10}, V{sub 20}, V{sub 30}, and V{sub 40} were 30%, 22%, 17%, and 11%, but its correlation with 2D parameters was poor. With a median follow-up of 14.5 months, 1 case of SRRP was identified. Conclusions: With only 1 case of SRRP observed, our study is limited in its ability to provide definitive guidance, but it does provide a starting point for acceptable lung irradiation during ABR. Further prospective studies are warranted.

• OSTI ID: 21367535
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 75, Issue 5; Other Information: DOI: 10.1016/j.ijrobp.2008.12.077; PII: S0360-3016(09)00092-3; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
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RADIATION DOSES
RADIOTHERAPY
THREE-DIMENSIONAL CALCULATIONS
VOLUMETRIC ANALYSIS
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