A novel technique for post-mastectomy breast irradiation utilising non-coplanar intensity-modulated radiation therapy
Identifieur interne : 002C95 ( Pmc/Corpus ); précédent : 002C94; suivant : 002C96A novel technique for post-mastectomy breast irradiation utilising non-coplanar intensity-modulated radiation therapy
Auteurs : M. Koshy ; B. Zhang ; S. Naqvi ; B. Liu ; M M MohiuddinSource :
- The British Journal of Radiology [ 0007-1285 ] ; 2010.
Abstract
The aim of this study was to investigate if non-coplanar intensity-modulated radiation therapy (IMRT) in the post-mastectomy setting can reduce the dose to normal structures and improve target coverage. We compared this IMRT technique with a standard partial wide tangential (PWT) plan and a five-field (5F) photon-electron plan. 10 patients who underwent left-sided mastectomy were planned to 50.4 Gy using either (1) PWT to cover the internal mammary (IM) nodes and supraclavicular fields, (2) 5F comprising standard tangents, supraclavicular fields and an electron field for the IM nodes or (3) IMRT. The planning target volume (PTV) included the left chest wall, supraclavicular, axillary and IM lymph nodes. No beams were directed at the right lung, right breast or heart. Mean dose–volume histograms were constructed by combining the dose–volume histogram data from all 10 patients. The mean PTV to receive 95% of the dose (V95%) was improved with the IMRT plan to 94.2% from 91.4% (
Url:
DOI: 10.1259/bjr/59469015
PubMed: 20223909
PubMed Central: 3473739
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PMC:3473739Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">A novel technique for post-mastectomy breast irradiation utilising non-coplanar intensity-modulated radiation therapy</title>
<author><name sortKey="Koshy, M" sort="Koshy, M" uniqKey="Koshy M" first="M" last="Koshy">M. Koshy</name>
</author>
<author><name sortKey="Zhang, B" sort="Zhang, B" uniqKey="Zhang B" first="B" last="Zhang">B. Zhang</name>
</author>
<author><name sortKey="Naqvi, S" sort="Naqvi, S" uniqKey="Naqvi S" first="S" last="Naqvi">S. Naqvi</name>
</author>
<author><name sortKey="Liu, B" sort="Liu, B" uniqKey="Liu B" first="B" last="Liu">B. Liu</name>
</author>
<author><name sortKey="Mohiuddin, M M" sort="Mohiuddin, M M" uniqKey="Mohiuddin M" first="M M" last="Mohiuddin">M M Mohiuddin</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">A novel technique for post-mastectomy breast irradiation utilising non-coplanar intensity-modulated radiation therapy</title>
<author><name sortKey="Koshy, M" sort="Koshy, M" uniqKey="Koshy M" first="M" last="Koshy">M. Koshy</name>
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<author><name sortKey="Zhang, B" sort="Zhang, B" uniqKey="Zhang B" first="B" last="Zhang">B. Zhang</name>
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<author><name sortKey="Naqvi, S" sort="Naqvi, S" uniqKey="Naqvi S" first="S" last="Naqvi">S. Naqvi</name>
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<author><name sortKey="Liu, B" sort="Liu, B" uniqKey="Liu B" first="B" last="Liu">B. Liu</name>
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<author><name sortKey="Mohiuddin, M M" sort="Mohiuddin, M M" uniqKey="Mohiuddin M" first="M M" last="Mohiuddin">M M Mohiuddin</name>
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<series><title level="j">The British Journal of Radiology</title>
<idno type="ISSN">0007-1285</idno>
<idno type="eISSN">1748-880X</idno>
<imprint><date when="2010">2010</date>
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<front><div type="abstract" xml:lang="en"><p>The aim of this study was to investigate if non-coplanar intensity-modulated radiation therapy (IMRT) in the post-mastectomy setting can reduce the dose to normal structures and improve target coverage. We compared this IMRT technique with a standard partial wide tangential (PWT) plan and a five-field (5F) photon-electron plan. 10 patients who underwent left-sided mastectomy were planned to 50.4 Gy using either (1) PWT to cover the internal mammary (IM) nodes and supraclavicular fields, (2) 5F comprising standard tangents, supraclavicular fields and an electron field for the IM nodes or (3) IMRT. The planning target volume (PTV) included the left chest wall, supraclavicular, axillary and IM lymph nodes. No beams were directed at the right lung, right breast or heart. Mean dose–volume histograms were constructed by combining the dose–volume histogram data from all 10 patients. The mean PTV to receive 95% of the dose (V95%) was improved with the IMRT plan to 94.2% from 91.4% (<italic>p</italic>
= 0.04) with the PWT plan and from 87.7% (<italic>p</italic>
= 0.012) with the 5F plan. The mean V110% of the PTV was improved to 3.6% for the IMRT plan from 16.8% (<italic>p</italic>
= 0.038) for the PWT plan and from 51.8% (<italic>p</italic>
= 0.001) for the 5F plan. The mean fraction volume receiving 30 Gy (v30Gy) of the heart was improved with the IMRT plan to 2.3% from 7.5% (<italic>p</italic>
= 0.01) for the PWT plan and 4.9% (<italic>p</italic>
= 0.02) for the 5F plan. In conclusion, non-coplanar IMRT results in improved coverage of the PTV and a lower heart dose when compared with a 5F or PWT plan.</p>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Br J Radiol</journal-id>
<journal-id journal-id-type="iso-abbrev">Br J Radiol</journal-id>
<journal-id journal-id-type="hwp">bjradio</journal-id>
<journal-id journal-id-type="publisher-id">bjr</journal-id>
<journal-title-group><journal-title>The British Journal of Radiology</journal-title>
</journal-title-group>
<issn pub-type="ppub">0007-1285</issn>
<issn pub-type="epub">1748-880X</issn>
<publisher><publisher-name>The British Institute of Radiology.</publisher-name>
<publisher-loc>36 Portland Place, London, W1B 1AT</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">20223909</article-id>
<article-id pub-id-type="pmc">3473739</article-id>
<article-id pub-id-type="publisher-id">D9067</article-id>
<article-id pub-id-type="doi">10.1259/bjr/59469015</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Full Paper</subject>
</subj-group>
</article-categories>
<title-group><article-title>A novel technique for post-mastectomy breast irradiation utilising non-coplanar intensity-modulated radiation therapy</article-title>
<alt-title alt-title-type="running-head">Non-coplanar intensity-modulated radiation therapy for breast cancer</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Koshy</surname>
<given-names>M</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Zhang</surname>
<given-names>B</given-names>
</name>
<degrees>CMD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Naqvi</surname>
<given-names>S</given-names>
</name>
<degrees>PhD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Liu</surname>
<given-names>B</given-names>
</name>
<degrees>PhD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Mohiuddin</surname>
<given-names>M M</given-names>
</name>
<degrees>MD</degrees>
</contrib>
</contrib-group>
<aff id="aff1"><addr-line>Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA</addr-line>
</aff>
<author-notes><corresp id="cor1">Matthew Koshy, MD, Department of Radiation Oncology, University of Maryland School of Medicine, 22 S. Greene St, Baltimore, MD 21201, USA. E-mail: <email>mkoshy@umm.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>10</month>
<year>2010</year>
</pub-date>
<volume>83</volume>
<issue>994</issue>
<fpage>874</fpage>
<lpage>881</lpage>
<history><date date-type="received"><day>16</day>
<month>1</month>
<year>2009</year>
</date>
<date date-type="rev-recd"><day>2</day>
<month>8</month>
<year>2009</year>
</date>
<date date-type="accepted"><day>12</day>
<month>10</month>
<year>2009</year>
</date>
</history>
<permissions><copyright-statement>© 2010 The British Institute of Radiology</copyright-statement>
<copyright-year>2010</copyright-year>
</permissions>
<abstract><p>The aim of this study was to investigate if non-coplanar intensity-modulated radiation therapy (IMRT) in the post-mastectomy setting can reduce the dose to normal structures and improve target coverage. We compared this IMRT technique with a standard partial wide tangential (PWT) plan and a five-field (5F) photon-electron plan. 10 patients who underwent left-sided mastectomy were planned to 50.4 Gy using either (1) PWT to cover the internal mammary (IM) nodes and supraclavicular fields, (2) 5F comprising standard tangents, supraclavicular fields and an electron field for the IM nodes or (3) IMRT. The planning target volume (PTV) included the left chest wall, supraclavicular, axillary and IM lymph nodes. No beams were directed at the right lung, right breast or heart. Mean dose–volume histograms were constructed by combining the dose–volume histogram data from all 10 patients. The mean PTV to receive 95% of the dose (V95%) was improved with the IMRT plan to 94.2% from 91.4% (<italic>p</italic>
= 0.04) with the PWT plan and from 87.7% (<italic>p</italic>
= 0.012) with the 5F plan. The mean V110% of the PTV was improved to 3.6% for the IMRT plan from 16.8% (<italic>p</italic>
= 0.038) for the PWT plan and from 51.8% (<italic>p</italic>
= 0.001) for the 5F plan. The mean fraction volume receiving 30 Gy (v30Gy) of the heart was improved with the IMRT plan to 2.3% from 7.5% (<italic>p</italic>
= 0.01) for the PWT plan and 4.9% (<italic>p</italic>
= 0.02) for the 5F plan. In conclusion, non-coplanar IMRT results in improved coverage of the PTV and a lower heart dose when compared with a 5F or PWT plan.</p>
</abstract>
</article-meta>
</front>
</pmc>
</record>
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