Initial dosimetric experience using simple three-dimensional conformal external-beam accelerated partial-breast irradiation

被引:76
作者
Taghian, AG
Kozak, KR
Doppke, KP
Katz, A
Smith, BL
Gadd, M
Specht, M
Hughes, K
Braaten, R
Kachnic, LA
Recht, A
Powell, SN
机构
[1] Massachusetts Gen Hosp, Dept Radiat Oncol, Boston, MA 02114 USA
[2] Massachusetts Gen Hosp, Dept Surg Oncol, Boston, MA 02114 USA
[3] Massachusetts Gen Hosp, Dept Breast Pathol, Boston, MA 02114 USA
[4] Boston Med Ctr, Dept Radiat Oncol, Boston, MA USA
[5] Beth Israel Deaconess Med Ctr, Dept Radiat Oncol, Boston, MA 02215 USA
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2006年 / 64卷 / 04期
关键词
breast cancer; accelerated partial-breast irradiation; simple 3D conformal external-beam irradiation;
D O I
10.1016/j.ijrobp.2005.09.042
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: Several accelerated partial-breast irradiation (APBI) techniques are being investigated in patients with early-stage breast cancer. We present our initial experience using three-dimensional conformal radiation therapy (3D-CRT). Methods and Materials: Sixty-one patients with tumors of 2 cm or less and negative axillary nodes were treated with 3D-CRT accelerated partial-breast irradiation (APBI) between August 2003 and March 2005. The prescribed radiation dose was 32 Gy in 4-Gy fractions given twice daily. Efforts were made to minimize the number of beams required to achieve adequate planning target volume (PTV) coverage. Results: A combination of photons and electrons was used in 85% of patients. A three-field technique that consisted of opposed, conformal tangential photons and enface electrons was employed in 43 patients (70%). Nine patients (15%) were treated with a four-field arrangement, which consisted of three photon fields and enface electrons. Mean PTV volumes that received 100%, 95%, and 90% of the prescribed dose were 93% +/- 7%, 97% +/- 4%, and 98% +/- 2%, respectively. Dose inhomogeneity exceeded 10% in only 7 patients (11%). Mean doses to the ipsilateral lung and heart were 1.8 Gy and 0.8 Gy, respectively. Conclusions: Simple 3D-CRT techniques of APBI can achieve appropriate PTV coverage while offering significant normal-tissue sparing. Therefore, this noninvasive approach may increase the availability of APBI to patients with early-stage breast cancer. (C) 2006 Elsevier Inc.
引用
收藏
页码:1092 / 1099
页数:8
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