Dose variability in different lymph node levels during locoregional breast cancer irradiation: the impact of deep-inspiration breath hold.
Strahlenther Onkol
; 195(1): 13-20, 2019 Jan.
Article
em En
| MEDLINE
| ID: mdl-30143814
ABSTRACT
PURPOSE:
Aim of the present analysis was to evaluate the movement and dose variability of the different lymph node levels of node-positive breast cancer patients during adjuvant radiotherapy (RT) with regional nodal irradiation (RNI) in deep-inspiration breath hold (DIBH).METHODS:
Thirty-five consecutive node-positive breast cancer patients treated from October 2016 to February 2018 receiving postoperative RT of the breast or chest wall including RNI of the supra-/infraclavicular lymph node levels (corresponding to levels IV, III, Rotter LN (interpectoral), and some parts of level II) were analyzed. To evaluate the lymph node level movement, a center of volume (COV) was obtained for each lymph node level for free-breathing (FB) and DIBH plans. Geometric shifts and dose differences between FB and DIBH were analyzed.RESULTS:
A significant movement of the COV in anterior (y) and cranial (z) dimensions was observed for lymph node levels I-II and Rotter lymph nodes (pâ¯< 0.001) due to DIBH. Only minor changes in the lateral dimension (x axis) were observed, without reaching significance for levels III, IV, and internal mammary. There was a significant difference in the mean dose of level I (DIBH vs. FB 38.2â¯Gy/41.3â¯Gy, pâ¯< 0.001) and level II (DIBH vs. FB 45.9â¯Gy/47.2â¯Gy, pâ¯< 0.001), while there was no significant difference in level III (pâ¯= 0.298), level IV (pâ¯= 0.476), or internal mammary nodes (pâ¯= 0.471).CONCLUSION:
A significant movement of the axillary lymph node levels was observed during DIBH in anterior and cranial directions for node-positive breast cancer patients in comparison to FB. The movement leads to a significant dose reduction in level I and level II.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Dosagem Radioterapêutica
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Neoplasias da Mama
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Carcinoma in Situ
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Radioterapia Conformacional
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Suspensão da Respiração
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Linfonodos
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Metástase Linfática
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
/
Middle aged
Idioma:
En
Revista:
Strahlenther Onkol
Assunto da revista:
NEOPLASIAS
/
RADIOTERAPIA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Alemanha