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

Journal Article · Tue Dec 01 04:00:00 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, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 5 Vol. 75; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
CARCINOMAS
CHEMICAL ANALYSIS
COMPUTERIZED TOMOGRAPHY
DIAGNOSTIC TECHNIQUES
DISEASES
DOSES
GLANDS
LUNGS
MAMMARY GLANDS
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PNEUMONITIS
QUANTITATIVE CHEMICAL ANALYSIS
RADIATION DOSES
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
THERAPY
THREE-DIMENSIONAL CALCULATIONS
TOMOGRAPHY
VOLUMETRIC ANALYSIS