BACKGROUND AND PURPOSE: To determine the optimal method of targeting breast and regional nodes in selected breast cancer patients after axillary dissection, we compared the results of IMRT versus no IMRT, and CT-informed versus clinically-placed fields, in supine and prone positions. MATERIALS AND METHODS: Twelve consecutive breast cancer patients simulated both prone and supine provided the images for this study. Four techniques were used to target breast, level III axilla, and supraclavicular fossa in either position: a traditional three-field three-dimensional conformal radiotherapy (3DCRT) plan, a four-field 3DCRT plan using a posterior axillary boost field, and two techniques using a CT-informed target volume consisting of an optimized 3DCRT plan (CT-planned 3D) and an intensity-modulated radiotherapy (IMRT) plan. The prescribed dose was 50 Gy in 25 fractions. RESULTS: CT-planned 3D and IMRT techniques improved nodal PTV coverage. Supine, mean nodal PTV V50 was 50% (3-field), 59% (4-field), 92% (CT-planned 3D), and 94% (IMRT). Prone, V50 was 29% (3-field), 42% (4-field), 97% (CT-planned 3D), and 95% (IMRT). Prone positioning, compared to supine, and IMRT technique, compared to 3D, lowered ipsilateral lung V20. CONCLUSIONS: Traditional 3DCRT plans provide inadequate nodal coverage. Prone IMRT technique resulted in optimal target coverage and reduced ipsilateral lung V20.
BACKGROUND AND PURPOSE: To determine the optimal method of targeting breast and regional nodes in selected breast cancerpatients after axillary dissection, we compared the results of IMRT versus no IMRT, and CT-informed versus clinically-placed fields, in supine and prone positions. MATERIALS AND METHODS: Twelve consecutive breast cancerpatients simulated both prone and supine provided the images for this study. Four techniques were used to target breast, level III axilla, and supraclavicular fossa in either position: a traditional three-field three-dimensional conformal radiotherapy (3DCRT) plan, a four-field 3DCRT plan using a posterior axillary boost field, and two techniques using a CT-informed target volume consisting of an optimized 3DCRT plan (CT-planned 3D) and an intensity-modulated radiotherapy (IMRT) plan. The prescribed dose was 50 Gy in 25 fractions. RESULTS: CT-planned 3D and IMRT techniques improved nodal PTV coverage. Supine, mean nodal PTV V50 was 50% (3-field), 59% (4-field), 92% (CT-planned 3D), and 94% (IMRT). Prone, V50 was 29% (3-field), 42% (4-field), 97% (CT-planned 3D), and 95% (IMRT). Prone positioning, compared to supine, and IMRT technique, compared to 3D, lowered ipsilateral lung V20. CONCLUSIONS: Traditional 3DCRT plans provide inadequate nodal coverage. Prone IMRT technique resulted in optimal target coverage and reduced ipsilateral lung V20.
Authors: Carolyn Taylor; Candace Correa; Frances K Duane; Marianne C Aznar; Stewart J Anderson; Jonas Bergh; David Dodwell; Marianne Ewertz; Richard Gray; Reshma Jagsi; Lori Pierce; Kathleen I Pritchard; Sandra Swain; Zhe Wang; Yaochen Wang; Tim Whelan; Richard Peto; Paul McGale Journal: J Clin Oncol Date: 2017-03-20 Impact factor: 44.544
Authors: E Fernández-Lizarbe; A Montero; A Polo; R Hernanz; R Morís; S Formenti; A Ramos Journal: Clin Transl Oncol Date: 2012-11-10 Impact factor: 3.405
Authors: Minji Koh; Jinhong Jung; Su Ssan Kim; Seung Do Ahn; Eun Kyung Choi; Il Yong Chung; Jong Won Lee; Sung-Bae Kim; Jae Ho Jeong Journal: Breast Cancer Res Treat Date: 2021-04-23 Impact factor: 4.872
Authors: Vicky Koh; Johann I Tang; Bok Ai Choo; Chek Wee Tan; Boon Keat Lim; Liang Shen; Jiade Jay Lu Journal: Onco Targets Ther Date: 2013-11-21 Impact factor: 4.147