Optimized Dose Coverage of Regional Lymph Nodes in Breast Cancer: The Role of Intensity-Modulated Radiotherapy
- Department of Radiation Oncology, Virginia Commonwealth University Medical Center, Richmond, VA (United States)
Purpose: To determine whether the use of intensity-modulated radiotherapy (IMRT) would lead to improved dosimetry for the breast and regional nodes. Methods and Materials: Ten patients with left-sided breast cancer were selected. The clinical target volume included left breast and internal mammillary (IM), supraclavicular (SC), and axillary (AX) nodes. The critical structures included heart, right and left lungs, contralateral breast, esophagus, thyroid, and humeral head. Conventional and a series of IMRT plans were generated for comparison. Results: The average heart D{sub 3} was reduced from 31.4 {+-} 18.9 with three-dimensional conformal radiotherapy (3D-CRT) to 15 {+-} 7.2 Gy with 9-field (9-FLD IMRT). The average left lung D{sub 30} was also decreased from 27.9 {+-} 11.5 Gy (3D-CRT) to 12.6 {+-} 8.2 Gy (9-FLD IMRT). The average contralateral breast D{sub 2} was reduced from 4.4 {+-} 5.3 Gy (3D-CRT) to 1.8 {+-} 1.2 Gy (4-FLD IMRT). Esophagus D{sub 2} was increased from 9.3 {+-} 8.1 Gy (3D-CRT) to 29.4 {+-} 5.4 (9-FLD IMRT); thyroid D{sub 50} was increased from 0.9 {+-} 0.6 Gy (3D-CRT) to 11.9 {+-} 6.6 (9-FLD IMRT); humeral head D{sub 2} was increased from 36.1 {+-} 13.1 Gy (3D-CRT) to 39.9 {+-} 6.5 (9-FLD IMRT). Conclusions: The use of IMRT improves breast and regional node coverage while decreasing doses to the lungs, heart, and contralateral breast when compared with 3D-CRT. Doses to esophagus, thyroid, and humeral head, however, were increased with IMRT.
- OSTI ID:
- 20953578
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 68, Issue 4; Other Information: DOI: 10.1016/j.ijrobp.2007.03.059; PII: S0360-3016(07)00663-3; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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