Dose coverage of axillary level I-III areas during whole breast irradiation with simplified intensity modulated radiation therapy in early stage breast cancer patients

被引：17

作者：

Zhang, Li ^{[1
]}

Yang, Zhao-zhi ^{[1
]}

Chen, Xing-xing ^{[1
]}

Tuan, Jeffrey ^{[3
]}

Ma, Jin-li ^{[1
]}

Mei, Xin ^{[1
]}

Yu, Xiao-li ^{[1
]}

Zhou, Zhi-rui ^{[1
]}

Shao, Zhi-min ^{[2
]}

Liu, Guang-yu ^{[2
]}

Guo, Xiao-mao ^{[1
]}

机构：

[1] Fudan Univ, Dept Radiat Oncol, Shanghai Canc Ctr, Dept Oncol,Shanghai Med Coll, Shanghai 200433, Peoples R China

[2] Fudan Univ, Dept Breast Surg, Shanghai Canc Ctr, Dept Oncol,Shanghai Med Coll, Shanghai 200433, Peoples R China

[3] Natl Canc Ctr Singapore, Dept Radiat Oncol, Singapore, Singapore

来源：

ONCOTARGET | 2015年 / 6卷 / 20期

基金：

中国国家自然科学基金;

关键词：

breast cancer; positive sentinel lymph nodes; radiotherapy; intensity modulated radiation therapy; axillary level; SENTINEL-NODE; TANGENTIAL FIELDS; RANDOMIZED-TRIAL; RADIOTHERAPY; MULTICENTER; DISSECTION; SURGERY; BIOPSY; WOMEN;

D O I：

10.18632/oncotarget.4301

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: This study was designed to evaluate the dose coverage of axillary areas during whole breast irradiation with simplified intensity modulated radiation therapy (s-IMRT) and field-in-field IMRT (for-IMRT) in early stage breast cancer patients. Methods: Sixty-one consecutive patients with breast-conserving surgery and sentinel lymph node biopsy were collected. Two plans were created for each patient: the s-IMRT and for-IMRT plan. Dosimetric parameters of axillary areas were compared. Results: The average of mean doses delivered to the axillary level I areas in s-IMRT and for-IMRT plan were 27.7Gy and 29.1Gy (p = 0.011), respectively. The average of V47.5Gy, V45Gy and V40Gy (percent volume receiving >= 47.5Gy, 45Gy and 40Gy) of the axillary level I in s-IMRT plan was significantly lower than that in for-IMRT plan (p < 0.001). For for-IMRT plans, patients with upper tangential border to humeral head <= 2cm, breast separation >19.3cm and body width >31.9cm had significantly higher mean dose in axillary level I area (p = 0.002, 0.007, 0.001, respectively). Conclusion: Compared with for-IMRT plan, the s-IMRT plan delivered lower dose to axillary level I area. For centers using s-IMRT technique, caution should be exercised when selecting to omit axillary lymph node dissection for patients with breast conserving surgery and limited positive SLNs.

引用

页码：18183 / 18191

页数：9

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