Combined photon-electron beams in the treatment of the supraclavicular lymph nodes in breast cancer: A novel technique that achieves adequate coverage while reducing lung dose
Abstract
Radiation pneumonitis is a well-documented side effect of radiation therapy for breast cancer. The purpose of this study was to compare combined photon-electron, photon-only, and electron-only plans in the radiation treatment of the supraclavicular lymph nodes. In total, 13 patients requiring chest wall and supraclavicular nodal irradiation were planned retrospectively using combined photon-electron, photon-only, and electron-only supraclavicular beams. A dose of 50 Gy over 25 fractions was prescribed. Chest wall irradiation parameters were fixed for all plans. The goal of this planning effort was to cover 95% of the supraclavicular clinical target volume (CTV) with 95% of the prescribed dose and to minimize the volume receiving ≥ 105% of the dose. Comparative end points were supraclavicular CTV coverage (volume covered by the 95% isodose line), hotspot volume, maximum radiation dose, contralateral breast dose, mean total lung dose, total lung volume percentage receiving at least 20 Gy (V{sub 20} {sub Gy}), heart volume percentage receiving at least 25 Gy (V{sub 25} {sub Gy}). Electron and photon energies ranged from 8 to 18 MeV and 4 to 6 MV, respectively. The ratio of photon-to-electron fractions in combined beams ranged from 5:20 to 15:10. Supraclavicular nodal coverage was highest in photon-only (mean =more »
- Authors:
-
- Department of Radiation Oncology, King Hussein Cancer Center, Amman (Jordan)
- Section of Medical Physics, Department of Radiation Oncology, King Hussein Cancer Center, Amman (Jordan)
- Department of Obstetrics and Gynecology, Hashemite University, Zarqa (Jordan)
- Publication Date:
- OSTI Identifier:
- 22462441
- Resource Type:
- Journal Article
- Journal Name:
- Medical Dosimetry
- Additional Journal Information:
- Journal Volume: 40; Journal Issue: 3; Other Information: Copyright (c) 2015 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0958-3947
- Country of Publication:
- United States
- Language:
- English
- Subject:
- 61 RADIATION PROTECTION AND DOSIMETRY; ANIMAL TISSUES; CHEST; COMPARATIVE EVALUATIONS; ELECTRON BEAMS; HEART; IRRADIATION; LUNGS; LYMPH NODES; MAMMARY GLANDS; NEOPLASMS; PATIENTS; PLANNING; PNEUMONITIS; RADIATION DOSES; RADIOTHERAPY
Citation Formats
Salem, Ahmed, Mohamad, Issa, Dayyat, Abdulmajeed, Kanaa’n, Haitham, Sarhan, Nasim, Roujob, Ibrahim, Salem, Abdel-Fattah, Afifi, Shatha, Jaradat, Imad, Mubiden, Rasmi, and Almousa, Abdelateif. Combined photon-electron beams in the treatment of the supraclavicular lymph nodes in breast cancer: A novel technique that achieves adequate coverage while reducing lung dose. United States: N. p., 2015.
Web. doi:10.1016/J.MEDDOS.2014.12.001.
Salem, Ahmed, Mohamad, Issa, Dayyat, Abdulmajeed, Kanaa’n, Haitham, Sarhan, Nasim, Roujob, Ibrahim, Salem, Abdel-Fattah, Afifi, Shatha, Jaradat, Imad, Mubiden, Rasmi, & Almousa, Abdelateif. Combined photon-electron beams in the treatment of the supraclavicular lymph nodes in breast cancer: A novel technique that achieves adequate coverage while reducing lung dose. United States. https://doi.org/10.1016/J.MEDDOS.2014.12.001
Salem, Ahmed, Mohamad, Issa, Dayyat, Abdulmajeed, Kanaa’n, Haitham, Sarhan, Nasim, Roujob, Ibrahim, Salem, Abdel-Fattah, Afifi, Shatha, Jaradat, Imad, Mubiden, Rasmi, and Almousa, Abdelateif. 2015.
"Combined photon-electron beams in the treatment of the supraclavicular lymph nodes in breast cancer: A novel technique that achieves adequate coverage while reducing lung dose". United States. https://doi.org/10.1016/J.MEDDOS.2014.12.001.
@article{osti_22462441,
title = {Combined photon-electron beams in the treatment of the supraclavicular lymph nodes in breast cancer: A novel technique that achieves adequate coverage while reducing lung dose},
author = {Salem, Ahmed and Mohamad, Issa and Dayyat, Abdulmajeed and Kanaa’n, Haitham and Sarhan, Nasim and Roujob, Ibrahim and Salem, Abdel-Fattah and Afifi, Shatha and Jaradat, Imad and Mubiden, Rasmi and Almousa, Abdelateif},
abstractNote = {Radiation pneumonitis is a well-documented side effect of radiation therapy for breast cancer. The purpose of this study was to compare combined photon-electron, photon-only, and electron-only plans in the radiation treatment of the supraclavicular lymph nodes. In total, 13 patients requiring chest wall and supraclavicular nodal irradiation were planned retrospectively using combined photon-electron, photon-only, and electron-only supraclavicular beams. A dose of 50 Gy over 25 fractions was prescribed. Chest wall irradiation parameters were fixed for all plans. The goal of this planning effort was to cover 95% of the supraclavicular clinical target volume (CTV) with 95% of the prescribed dose and to minimize the volume receiving ≥ 105% of the dose. Comparative end points were supraclavicular CTV coverage (volume covered by the 95% isodose line), hotspot volume, maximum radiation dose, contralateral breast dose, mean total lung dose, total lung volume percentage receiving at least 20 Gy (V{sub 20} {sub Gy}), heart volume percentage receiving at least 25 Gy (V{sub 25} {sub Gy}). Electron and photon energies ranged from 8 to 18 MeV and 4 to 6 MV, respectively. The ratio of photon-to-electron fractions in combined beams ranged from 5:20 to 15:10. Supraclavicular nodal coverage was highest in photon-only (mean = 96.2 ± 3.5%) followed closely by combined photon-electron (mean = 94.2 ± 2.5%) and lowest in electron-only plans (mean = 81.7 ± 14.8%, p < 0.001). The volume of tissue receiving ≥ 105% of the prescription dose was higher in the electron-only (mean = 69.7 ± 56.1 cm{sup 3}) as opposed to combined photon-electron (mean = 50.8 ± 40.9 cm{sup 3}) and photon-only beams (mean = 32.2 ± 28.1 cm{sup 3}, p = 0.114). Heart V{sub 25} {sub Gy} was not statistically different among the plans (p = 0.999). Total lung V{sub 20} {sub Gy} was lowest in electron-only (mean = 10.9 ± 2.3%) followed by combined photon-electron (mean = 13.8 ± 2.3%) and highest in photon-only plans (mean = 16.2 ± 3%, p < 0.001). As expected, photon-only plans demonstrated the highest target coverage and total lung V{sub 20} {sub Gy}. The superiority of electron-only beams, in terms of decreasing lung dose, is set back by the dosimetric hotspots associated with such plans. Combined photon-electron treatment is a feasible technique for supraclavicular nodal irradiation and results in adequate target coverage, acceptable dosimetric hotspot volume, and slightly reduced lung dose.},
doi = {10.1016/J.MEDDOS.2014.12.001},
url = {https://www.osti.gov/biblio/22462441},
journal = {Medical Dosimetry},
issn = {0958-3947},
number = 3,
volume = 40,
place = {United States},
year = {Thu Oct 01 00:00:00 EDT 2015},
month = {Thu Oct 01 00:00:00 EDT 2015}
}