TITLE:
Use of Three Dimensional Conformal Radiation Therapy for Node Positive Breast Cancer Does Not Result in Excess Lung and Heart Irradiation
AUTHORS:
Phillip Prior, Irina Sparks, J. Frank Wilson, Joseph Bovi, Adam Currey, Julie Bradley, Tracy Kelly, X. Allen Li, Julia R White
KEYWORDS:
Node Positive Breast Cancer, Dose-Volume Goals, Target Coverage, CT Based Planning
JOURNAL NAME:
International Journal of Medical Physics, Clinical Engineering and Radiation Oncology,
Vol.6 No.1,
January
11,
2017
ABSTRACT: Purpose: This work evaluates the use of target and organs at risk (OAR) dose-volume
goals in 3D conformal radiotherapy (3DCRT) planning for node positive breast
cancer (NPBC) patients undergoing regional nodal irradiation after
lumpectomy/mastectomy. Methods: Dosimetric data for 262 NPBC
patients receiving regional nodal and whole breast/chest wall (WB/CW) irradiation
from 2000-2009 were analyzed. In all cases, target & OAR volumes were
delineated on treatment CT scans for field generation and dose-volume
histograms (DVHs) were generated. Cases were analyzed to identify how
frequently they met treatment planning institutional dose-volume goals
(“institutional guidelines” & standardized in 2005) and how this would
affect OAR doses. Results: The incidence of cases from 2000-2009
meeting current institutional guidelines improved over the study period. Target
coverage improved from 2005-2009, when guidelines were followed as a part of the
plan approval. Those cases from 2000-2004 meeting acceptable target goals were
found to be significantly different from those cases from 2005-2009 (p Conclusions: The
use of institutional guidelines in 3DCRT for WB/CW and regional nodal
irradiation for NPBC patients improved target coverage without a statistically
significant increase in heart and lung doses.