Optimized dose coverage of regional lymph nodes in breast cancer: The role of intensity-modulated radiotherapy
Optimized dose coverage of regional lymph nodes in breast cancer: The role of intensity-modulated radiotherapy
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DOI：
10.1016/j.ijrobp.2007.03.059
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发表时间：
2007-07-15
影响因子：
7
通讯作者：
Arthur, Douglas W.
中科院分区：
文献类型：
--
作者：
Dogan, Nesrin;Cuttino, Laurie;Arthur, Douglas W.
目的：为了确定是否使用调强放射治疗（IMRT）将导致改善乳腺和区域nodes.Methods和材料的剂量测定：10例左侧乳腺癌被选中。临床靶体积包括左乳房和内乳头（IM）、锁骨上（SC）和腋窝（AX）淋巴结。关键结构包括心脏、左右肺、对侧乳房、食管、甲状腺和肱骨头。结果：平均心脏D-3从三维适形放疗（3D-CRT）的31.4 ± 18.9减少到9野（9-FLD IMRT）的15 ± 7.2戈伊。左肺平均D-30也从27.9 +/- 11.5戈伊（3D-CRT）降至12.6 +/- 8.2戈伊（9-FLD IMRT）。平均对侧乳房D-2从4.4 +/- 5.3戈伊（3D-CRT）降至1.8 +/- 1.2戈伊（4-FLD IMRT）。食管D2从9.3 +/- 8.1戈伊（3D-CRT）增加至29.4 +/- 5.4（9-FLD IMRT）;甲状腺D-50从0.9 +/- 0.6戈伊（3D-CRT）增加至11.9 +/- 6.6（9-FLD IMRT）;肱骨头D-2从36.1 +/- 13.1戈伊（3D-CRT）增加至39.9 +/- 6.5（9-FLD IMRT）.结论：与3D-CRT相比，IMRT的使用改善了乳腺和区域淋巴结覆盖，同时降低了肺、心脏和对侧乳腺的剂量。然而，食管、甲状腺和肱骨头的剂量随着调强放疗而增加。(C)2007年爱思唯尔公司
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-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 D2 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).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. (C) 2007 Elsevier Inc.