Hostname: page-component-6d856f89d9-nr6nt Total loading time: 0 Render date: 2024-07-16T06:38:16.111Z Has data issue: false hasContentIssue false
  • English
  • Français

Dosimetric comparison of level II lymph nodes between mono-isocentric and dual-isocentric approaches in 3D-CRT and IMRT techniques in breast radiotherapy of mastectomy patients

Published online by Cambridge University Press:  03 September 2019

Saba Nadi ,
Razzagh Abedi-Firouzjah ,
Amin Banaei Open the ORCID record for Amin Banaei [Opens in a new window] ,
Salar Bijari  and
Mahdi Elahi
Saba Nadi
Affiliation:
Department of Medical Physics, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
Razzagh Abedi-Firouzjah
Affiliation:
Department of Medical Physics, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
Amin Banaei*
Affiliation:
Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran Department of Radiology Technology, Faculty of Paramedical Sciences, Aja University of Medical Sciences, Tehran, Iran
Salar Bijari
Affiliation:
Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
Mahdi Elahi
Affiliation:
Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
*
Author for correspondence: Amin Banaei, Tarbiat Modares University Faculty of Medical Sciences, Jala-e-Al ahmad, Tehran, Tehran 14115111, Iran. E-mail: amin.banaii@modares.ac.ir
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim:

To evaluate the dosimetric parameters of level II lymph nodes in chest wall three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) of mastectomy patients using dual-isocentric (DIT) and mono-isocentric techniques (MIT).

Materials and methods:

Computed tomography (CT) images of 20 mastectomy patients undergoing chest wall external radiotherapy were used as the input data for the abovementioned techniques. Selected dosimetric parameters were calculated for the axillary level I–III lymph nodes, chest wall, heart and lung. Paired t-test statistical analysis was used for comparing the results of MIT and DIT in both 3D-CRT and IMRT methods.

Results:

There were significant differences in Dmin (minimum dose), Dmax (maximum dose) and maximum–minimum dose between MIT and DIT techniques (13, −8·6, −52·2% differences for Dmin, Dmax and maximum–minimum, respectively) in IMRT. There were also significant differences for Dmean (mean dose), Dmax and maximum–minimum dose (7·8, −11·4, −44·6% differences in Dmean, Dmax and maximum–minimum, respectively) in 3D-CRT (p < 0·05). In addition, there were not any differences in the dosimetric parameters for heart, lung and level I and III lymph nodes.

Conclusion:

In both 3D-CRT and IMRT methods, level II lymph node dose distribution in MIT was closer to the prescribed dose compared with DIT due to the position of these nodes in the field junction area. To achieve a better dose homogeneity, it could be recommended to use MIT instead of DIT in 3D-CRT and IMRT for mastectomy patients.

Keywords

3D-CRTbreast cancerIMRTlymph nodesmono-isocentric technique
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 19 , Issue 3 , September 2020 , pp. 254 - 258
Copyright
© Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Firouzjah, R A, Banaei, A, Farhood, B, Bakhshandeh, M.Dosimetric comparison of four different techniques for supraclavicular irradiation in 3D-conformal radiotherapy of breast cancer. Health Phys 2019; 116 (5): 631–636.CrossRefGoogle ScholarPubMed
Brown, L C, Mutter, R W, Halyard, M Y. Benefits, risks, and safety of external beam radiation therapy for breast cancer. Int J Womens Health 2015; 7: 449.Google ScholarPubMed
Ma, C, Zhang, W, Lu, Jet al.Dosimetric comparison and evaluation of three radiotherapy techniques for use after modified radical mastectomy for locally advanced left-sided breast cancer. Sci Rep 2015; 5: 12274.CrossRefGoogle ScholarPubMed
Abdi Goushbolagh, N, Abedi Firouzjah, R, Ebrahimnejad Gorji, Ket al.Estimation of radiation dose-reduction factor for cerium oxide nanoparticles in MRC-5 human lung fibroblastic cells and MCF-7 breast-cancer cells. Artif Cells Nanomed Biotechnol 2018; 46 (suppl3): S1215–S1225.CrossRefGoogle ScholarPubMed
Khan, F M, Gerbi, B J.Treatment Planning in Radiation Oncology, 3rd edition. Philadelphia, USA: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2012.Google Scholar
Banaei, A, Bakhshandeh, M, Mirzaei, H.Introducing a new conformal mono-isocentric technique in the chest wall external radiotherapy for the mastectomy patients. Paramed Sci Mil Health 2015; 10 (1): 1–8.Google Scholar
Halperin, E C, Brady, L W, Perez, C A, Perez & Brady’s Principles and Practice of Radiation Oncology, 6th edition. Philadelphia, USA: Lippincott Williams & Wilkins, 2013.Google Scholar
Mani, K R, Poudel, S, Das, K M.Comparison of cardiac and lung doses for breast cancer patients with free breathing and deep inspiration breath hold technique in 3 dimensional conformal radiotherapy-a dosimetric study. Polish J Med Phys Eng 2017; 23 (4): 109–114.CrossRefGoogle Scholar
Santiago, R J, Wu, L, Harris, Eet al.Fifteen-year results of breast-conserving surgery and definitive irradiation for Stage I and II breast carcinoma: the University of Pennsylvania experience. Int J Radiat Oncol Biol Phys 2004; 58 (1): 233–240.CrossRefGoogle Scholar
Veronesi, U, Cascinelli, N, Mariani, Let al.Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 2002; 347 (16): 1227–1232.CrossRefGoogle ScholarPubMed
Fisher, B, Anderson, S, Bryant, Jet al.Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 2002; 347 (16): 1233–1241.CrossRefGoogle ScholarPubMed
Tsoutsou, P G, Vozenin, M-C, Durham, A-D, Bourhis, J.How could breast cancer molecular features contribute to locoregional treatment decision making? Crit Rev Oncol Hematol 2017; 110: 43–48.CrossRefGoogle ScholarPubMed
Abdulmoniem, R, Bayoumi, Y, Al Asiri, Met al.Risk of radiation induced carotid artery stenosis in supraclavicular lymph node irradiation in breast cancer patients. J Cancer Ther 2014; 5 (5): 238–245.CrossRefGoogle Scholar
Cheung, K.Intensity modulated radiotherapy: advantages, limitations and future developments. Biomed Imaging Interv J 2006; 2 (2): 19–37.CrossRefGoogle ScholarPubMed
Court, L E, Seco, J, Lu, X Qet al.Use of a realistic breathing lung phantom to evaluate dose delivery errors. Med Phys 2010; 37 (11): 5850–5857.CrossRefGoogle ScholarPubMed
Moon, S H, Shin, K H, Kim, T Het al.Dosimetric comparison of four different external beam partial breast irradiation techniques: three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, helical tomotherapy, and proton beam therapy. Radiother Oncol 2009; 90 (1): 66–73.CrossRefGoogle ScholarPubMed
Bland, K I, Copeland, E M, Gradishar, W J, Klimberg, V S. The Breast: Comprehensive Management of Benign and Malignant Diseases. Philadelphia London Toronto Montreal Sydney Tokyo: Saunders, 1991.Google Scholar
Assaoui, F, Toulba, A, Nouh, Met al.Mono-isocentric technique in the breast cancer and organ at risk tolerance. J Nucl Med Radiat Ther 2012; S2: 010.Google Scholar
Spratt, J S.Locally recurrent cancer after radical mastectomy. Cancer 1967; 20 (7): 1051–1053.3.0.CO;2-D>CrossRefGoogle ScholarPubMed
Henderson, I C, Canellos, G P.Cancer of the breast: the past decade. N Engl J Med 1980; 302 (1): 17–30.CrossRefGoogle Scholar
Jemal, A, Siegel, R, Ward, Eet al.Cancer statistics, 2008. CA: A Cancer J Clin 2008; 58 (2): 71–96.Google ScholarPubMed
Abo-Madyan, Y, Aziz, M H, Aly, M Met al.Second cancer risk after 3D-CRT, IMRT and VMAT for breast cancer. Radiother Oncol 2014; 110 (3): 471–476.CrossRefGoogle ScholarPubMed
Banaei, A, Hashemi, B, Bakhshandeh, M.Comparing the monoisocentric and dual isocentric techniques in chest wall radiotherapy of mastectomy patients. J Appl Clin Med Phys 2015; 16 (1): 130–138.CrossRefGoogle ScholarPubMed
Romeo, N.A new isocentric technique for exact geometric matching in the radiotherapy of the breast and ipsilateral supraclavicular fossa using dual asymmetric jaws. Phys Med 2012; 28 (4): 281–287.CrossRefGoogle ScholarPubMed
Milano, M T, Constine, L S, Okunieff, P.Normal tissue tolerance dose metrics for radiation therapy of major organs. Semin Radiat Oncol 2007; 17 (2): 131–140.CrossRefGoogle ScholarPubMed
Prasana Sarathy, N (ed.). Evaluation of three dimensional conformal versus field in field forward IMRT planning for intact breast irradiation. International conference on Medical Physics and twenty ninth annual conference of Association of Medical Physicists of India: souvenir and book of abstracts. Mumbai, India: Association of Medical Physicists of India, 2008: 32–33.Google Scholar
Paddick, I.A simple scoring ratio to index the conformity of radiosurgical treatment plans: technical note. J Neurosurg 2000; 93 (suppl 3), 219–222.CrossRefGoogle ScholarPubMed
Lee, B, Lee, S, Sung, J, Yoon, M.Radiotherapy-induced secondary cancer risk for breast cancer: 3D conformal therapy versus IMRT versus VMAT. J Radiol Prot 2014; 34 (2): 325.CrossRefGoogle ScholarPubMed
Marshall, M G.Three-field isocentric breast irradiation using asymmetric jaws and a tilt board. Radiother Oncol 1993; 28 (3): 228–232.CrossRefGoogle Scholar
Yavetz, D, Corn, B W, Matceyevsky, Det al.Improved treatment of the breast and supraclavicular fossa based on a simple geometrical principle. Med Dosim 2011; 36 (4): 434–439.CrossRefGoogle ScholarPubMed
Edlund, T, Gannett, D.A single isocenter technique using CT-based planning in the treatment of breast cancer. Med Dosim 1999; 24 (4): 239–245.CrossRefGoogle ScholarPubMed
Lefkopoulos, D, Levrier, M, Bendada, S, Touboul, E.A general optimization procedure for stereotactic small-beam multi-isocentric radiotherapy. Int J Imaging Syst Technol 1995; 6 (1): 114–123.CrossRefGoogle Scholar