Dose coverage of axillary level I-III areas during whole breast irradiation with simplified intensity modulated radiation therapy in early stage breast cancer patients
Identifieur interne : 001E84 ( Main/Exploration ); précédent : 001E83; suivant : 001E85Dose coverage of axillary level I-III areas during whole breast irradiation with simplified intensity modulated radiation therapy in early stage breast cancer patients
Auteurs : Li Zhang [République populaire de Chine] ; Zhao-Zhi Yang [République populaire de Chine] ; Xing-Xing Chen [République populaire de Chine] ; Jeffrey Tuan [Singapour] ; Jin-Li Ma [République populaire de Chine] ; Xin Mei [République populaire de Chine] ; Xiao-Li Yu [République populaire de Chine] ; Zhi-Rui Zhou [République populaire de Chine] ; Zhi-Min Shao [République populaire de Chine] ; Guang-Yu Liu [République populaire de Chine] ; Xiao-Mao Guo [République populaire de Chine]Source :
- Oncotarget [ 1949-2553 ] ; 2015.
Abstract
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.
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.
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 (
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.
Url:
PubMed: 26082440
PubMed Central: 4627244
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Dose coverage of axillary level I-III areas during whole breast irradiation with simplified intensity modulated radiation therapy in early stage breast cancer patients</title><author><name sortKey="Zhang, Li" sort="Zhang, Li" uniqKey="Zhang L" first="Li" last="Zhang">Li Zhang</name><affiliation wicri:level="1"><nlm:aff id="A1"> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Yang, Zhao Zhi" sort="Yang, Zhao Zhi" uniqKey="Yang Z" first="Zhao-Zhi" last="Yang">Zhao-Zhi Yang</name><affiliation wicri:level="1"><nlm:aff id="A1"> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Chen, Xing Xing" sort="Chen, Xing Xing" uniqKey="Chen X" first="Xing-Xing" last="Chen">Xing-Xing Chen</name><affiliation wicri:level="1"><nlm:aff id="A1"> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea> Department of Radiation 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Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Mei, Xin" sort="Mei, Xin" uniqKey="Mei X" first="Xin" last="Mei">Xin Mei</name><affiliation wicri:level="1"><nlm:aff id="A1"> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Yu, Xiao Li" sort="Yu, Xiao Li" uniqKey="Yu X" first="Xiao-Li" last="Yu">Xiao-Li Yu</name><affiliation wicri:level="1"><nlm:aff id="A1"> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Zhou, Zhi Rui" sort="Zhou, Zhi Rui" uniqKey="Zhou Z" first="Zhi-Rui" last="Zhou">Zhi-Rui Zhou</name><affiliation wicri:level="1"><nlm:aff id="A1"> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Shao, Zhi Min" sort="Shao, Zhi Min" uniqKey="Shao Z" first="Zhi-Min" last="Shao">Zhi-Min Shao</name><affiliation wicri:level="1"><nlm:aff id="A2"> Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea> Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Liu, Guang Yu" sort="Liu, Guang Yu" uniqKey="Liu G" first="Guang-Yu" last="Liu">Guang-Yu Liu</name><affiliation wicri:level="1"><nlm:aff id="A2"> Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea> Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Guo, Xiao Mao" sort="Guo, Xiao Mao" uniqKey="Guo X" first="Xiao-Mao" last="Guo">Xiao-Mao Guo</name><affiliation wicri:level="1"><nlm:aff id="A1"> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26082440</idno><idno type="pmc">4627244</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4627244</idno><idno type="RBID">PMC:4627244</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000387</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000387</idno><idno type="wicri:Area/Pmc/Curation">000387</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000387</idno><idno type="wicri:Area/Pmc/Checkpoint">001332</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001332</idno><idno type="wicri:Area/Ncbi/Merge">007497</idno><idno 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Department of Oncology, Shanghai Medical College, Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Yang, Zhao Zhi" sort="Yang, Zhao Zhi" uniqKey="Yang Z" first="Zhao-Zhi" last="Yang">Zhao-Zhi Yang</name><affiliation wicri:level="1"><nlm:aff id="A1"> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Chen, Xing Xing" sort="Chen, Xing Xing" uniqKey="Chen X" first="Xing-Xing" last="Chen">Xing-Xing Chen</name><affiliation wicri:level="1"><nlm:aff id="A1"> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Tuan, Jeffrey" sort="Tuan, Jeffrey" uniqKey="Tuan J" first="Jeffrey" last="Tuan">Jeffrey Tuan</name><affiliation wicri:level="1"><nlm:aff id="A3"> Department of Radiation Oncology, National Cancer Centre Singapore, Singapore</nlm:aff><country xml:lang="fr">Singapour</country><wicri:regionArea> Department of Radiation Oncology, National Cancer Centre Singapore</wicri:regionArea><wicri:noRegion>National Cancer Centre Singapore</wicri:noRegion></affiliation></author><author><name sortKey="Ma, Jin Li" sort="Ma, Jin Li" uniqKey="Ma J" first="Jin-Li" last="Ma">Jin-Li Ma</name><affiliation wicri:level="1"><nlm:aff id="A1"> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Mei, Xin" sort="Mei, Xin" uniqKey="Mei X" first="Xin" last="Mei">Xin Mei</name><affiliation wicri:level="1"><nlm:aff id="A1"> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Yu, Xiao Li" sort="Yu, Xiao Li" uniqKey="Yu X" first="Xiao-Li" last="Yu">Xiao-Li Yu</name><affiliation wicri:level="1"><nlm:aff id="A1"> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Zhou, Zhi Rui" sort="Zhou, Zhi Rui" uniqKey="Zhou Z" first="Zhi-Rui" last="Zhou">Zhi-Rui Zhou</name><affiliation wicri:level="1"><nlm:aff id="A1"> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Shao, Zhi Min" sort="Shao, Zhi Min" uniqKey="Shao Z" first="Zhi-Min" last="Shao">Zhi-Min Shao</name><affiliation wicri:level="1"><nlm:aff id="A2"> Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea> Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Liu, Guang Yu" sort="Liu, Guang Yu" uniqKey="Liu G" first="Guang-Yu" last="Liu">Guang-Yu Liu</name><affiliation wicri:level="1"><nlm:aff id="A2"> Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea> Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Guo, Xiao Mao" sort="Guo, Xiao Mao" uniqKey="Guo X" first="Xiao-Mao" last="Guo">Xiao-Mao Guo</name><affiliation wicri:level="1"><nlm:aff id="A1"> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea> Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author></analytic><series><title level="j">Oncotarget</title><idno type="eISSN">1949-2553</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>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.</p></sec><sec><title>Methods</title><p>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.</p></sec><sec><title>Results</title><p>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 (<italic>p</italic> = 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 (<italic>p</italic> < 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 (<italic>p</italic> = 0.002, 0.007, 0.001, respectively).</p></sec><sec><title>Conclusion</title><p>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.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Lyman, Gh" uniqKey="Lyman G">GH Lyman</name></author><author><name sortKey="Giuliano, Ae" uniqKey="Giuliano A">AE Giuliano</name></author><author><name sortKey="Somerfield, Mr" uniqKey="Somerfield M">MR Somerfield</name></author><author><name sortKey="Benson, Ab" uniqKey="Benson A">AB Benson</name></author><author><name sortKey="Bodurka, Dc" uniqKey="Bodurka D">DC Bodurka</name></author><author><name sortKey="Burstein, Hj" uniqKey="Burstein H">HJ Burstein</name></author><author><name sortKey="Cochran, Aj" uniqKey="Cochran A">AJ Cochran</name></author><author><name sortKey="Cody, Hs" uniqKey="Cody H">HS Cody</name></author><author><name sortKey="Edge, Sb" uniqKey="Edge S">SB 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Buchholz</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>République populaire de Chine</li><li>Singapour</li></country></list><tree><country name="République populaire de Chine"><noRegion><name sortKey="Zhang, Li" sort="Zhang, Li" uniqKey="Zhang L" first="Li" last="Zhang">Li Zhang</name></noRegion><name sortKey="Chen, Xing Xing" sort="Chen, Xing Xing" uniqKey="Chen X" first="Xing-Xing" last="Chen">Xing-Xing Chen</name><name sortKey="Guo, Xiao Mao" sort="Guo, Xiao Mao" uniqKey="Guo X" first="Xiao-Mao" last="Guo">Xiao-Mao Guo</name><name sortKey="Liu, Guang Yu" sort="Liu, Guang Yu" uniqKey="Liu G" first="Guang-Yu" last="Liu">Guang-Yu Liu</name><name sortKey="Ma, Jin Li" sort="Ma, Jin Li" uniqKey="Ma J" first="Jin-Li" last="Ma">Jin-Li Ma</name><name sortKey="Mei, Xin" sort="Mei, Xin" uniqKey="Mei X" first="Xin" last="Mei">Xin Mei</name><name sortKey="Shao, Zhi Min" sort="Shao, Zhi Min" uniqKey="Shao Z" first="Zhi-Min" last="Shao">Zhi-Min Shao</name><name sortKey="Yang, Zhao Zhi" sort="Yang, Zhao Zhi" uniqKey="Yang Z" first="Zhao-Zhi" last="Yang">Zhao-Zhi Yang</name><name sortKey="Yu, Xiao Li" sort="Yu, Xiao Li" uniqKey="Yu X" first="Xiao-Li" last="Yu">Xiao-Li Yu</name><name sortKey="Zhou, Zhi Rui" sort="Zhou, Zhi Rui" uniqKey="Zhou Z" first="Zhi-Rui" last="Zhou">Zhi-Rui Zhou</name></country><country name="Singapour"><noRegion><name sortKey="Tuan, Jeffrey" sort="Tuan, Jeffrey" uniqKey="Tuan J" first="Jeffrey" last="Tuan">Jeffrey Tuan</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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