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      Optimized Dose Coverage of Regional Lymph Nodes in Breast Cancer: The Role of Intensity-Modulated Radiotherapy

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      International Journal of Radiation Oncology*Biology*Physics

      Elsevier BV

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          Abstract

          To determine whether the use of intensity-modulated radiotherapy (IMRT) would lead to improved dosimetry for the breast and regional nodes. 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. The average heart D(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(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(2) was reduced from 4.4 +/- 5.3 Gy (3D-CRT) to 1.8 +/- 1.2 Gy (4-FLD IMRT). Esophagus D(2) was increased from 9.3 +/- 8.1 Gy (3D-CRT) to 29.4 +/- 5.4 (9-FLD IMRT); thyroid D(50) was increased from 0.9 +/- 0.6 Gy (3D-CRT) to 11.9 +/- 6.6 (9-FLD IMRT); humeral head D(2) was increased from 36.1 +/- 13.1 Gy (3D-CRT) to 39.9 +/- 6.5 (9-FLD IMRT). 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.

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          Author and article information

          Journal
          International Journal of Radiation Oncology*Biology*Physics
          International Journal of Radiation Oncology*Biology*Physics
          Elsevier BV
          03603016
          July 2007
          July 2007
          : 68
          : 4
          : 1238-1250
          Article
          10.1016/j.ijrobp.2007.03.059
          17512134
          © 2007

          https://www.elsevier.com/tdm/userlicense/1.0/

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