Article (Scientific journals)
Multisegmented tangential breast fields: A rational way to treat breast cancer
GULYBAN, Akos; Kovács, P.; Sebestyén, Z. et al.
2008In Strahlentherapie und Onkologie, 184 (5), p. 262-269
Peer Reviewed verified by ORBi
 

Files


Full Text
Gulyban et al. - 2008 - Multisegmented tangential breast fields a rational way to treat breast cancer. - Strahlenther Onkol.pdf
Publisher postprint (458.84 kB)
Request a copy

All documents in ORBi are protected by a user license.

Send to



Details



Keywords :
Breast cancer; Dose homogeneity; Dummy structure; IMRT; Plan optimization; Segmented beams; Body Burden; Breast; Breast Neoplasms; Female; Heart; Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Lung; Radiotherapy Dosage; Radiotherapy Planning, Computer-Assisted; Radiotherapy, Conformal; Radiotherapy, Intensity-Modulated; Tomography, X-Ray Computed
Abstract :
[en] Purpose: Using three-dimensional conformal radiation therapy (3D-CRT) and multisegmented conformal radiation therapy (MS-CRT) for breast cancer treatment, the dose coverage of the planning target volume (PTV) and the radiation burden on the organs at risk (OARs) were evaluated. Material and Methods: 3D-CRT and MS-CRT were planned for 436 unilateral breasts (217 left). All patients were treated with MS-CRT between 2005 and 2007. For PTV delineation and beam orientation, supportive structures were applied. The mean PTV was 1,130 cm 3 (in ten patients > 2,200 cm3). Three-dimensional planning with weight-optimized medial and lateral open fields at a total dose of 50.4/1.8 Gy was followed by multisegmented planning with a reasonably high-dose-level dose cloud to define the medial subfield, and renewed optimization. This was repeated for the lateral subfield with a final optimization. For PTV coverage evaluation, the ICRU 50 was considered: the PTV portions receiving 95-107%, < 95% and > 107% of the prescribed dose (PTVD95- 107%, PTV<D95% and PTV>D107%), and the PTV maximal dose (PTVDmax). To compare the OAR radiation burdens, the mean doses to the ipsi-/contralateral lung, contralateral breast, and whole heart were documented. Results: The multisegmented plans furnished significantly (p < 0.0001) better target coverage (PTVD95-107% 82.8% vs. 90.9%, PTV<D95% 11.4% vs. 8.8%, PTV>D107% 5.9% vs. 0.3% and PTVDmax 56.6 vs. 54.3 Gy). The mean OAR doses remained almost unchanged: ipsilateral lung 10.5 versus 10.4 Gy, contralateral lung 0.4 versus 0.4 Gy, contralateral breast 0.8 versus 0.8 Gy, and whole heart (for left-sided cancers) 4.8 versus 4.8 Gy. The subfields required a mean of 9.8 MU (monitor units), i.e., a mean total 7.6 MU increment. The planning took 10-20 min, and the delivery 5-10 min. Conclusion: MS-CRT is a good alternative to breast intensity-modulated radiation therapy (IMRT) and seems adequate for right-sided cancers, whereas left-sided cancers necessitate a longer follow-up of heart-related side effects before a final assessment. © 2008 Urban & Vogel.
Disciplines :
Radiology, nuclear medicine & imaging
Author, co-author :
GULYBAN, Akos ;  Centre Hospitalier Universitaire de Liège - CHU > Radiothérapie
Kovács, P.;  Department of Oncotherapy, University of Pécs, Hungary
Sebestyén, Z.;  Department of Oncotherapy, University of Pécs, Hungary
Farkas, R.;  Department of Oncotherapy, University of Pécs, Hungary
Csere, T.;  Department of Oncotherapy, University of Pécs, Hungary
Karácsonyi, G.;  Department of Oncotherapy, University of Pécs, Hungary
Dérczy, K.;  Department of Oncotherapy, University of Pécs, Hungary
Hideghéty, K.;  Department of Oncotherapy, University of Pécs, Hungary, Department of Oncotherapy, University of Szeged, Hungary
Ésik, O.;  Department of Oncotherapy, University of Pécs, Hungary, Department of Radiation and Medical Oncology, Medcenter Ltd., Borsod Country Hospital, Miskolc, Hungary
Language :
English
Title :
Multisegmented tangential breast fields: A rational way to treat breast cancer
Publication date :
2008
Journal title :
Strahlentherapie und Onkologie
ISSN :
0179-7158
eISSN :
1439-099X
Publisher :
Urban & Vogel, Munchen, Germany
Volume :
184
Issue :
5
Pages :
262-269
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 20 June 2013

Statistics


Number of views
56 (4 by ULiège)
Number of downloads
0 (0 by ULiège)

Scopus citations®
 
31
Scopus citations®
without self-citations
26
OpenCitations
 
29

Bibliography


Similar publications



Contact ORBi