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- W2000997424 abstract "The recent advances in diagnosis and treatment of breast cancer have resulted in an increasing number of long-term survivors. However, this population has suffered the consequences of breast cancer treatment, which usually involves radiotherapy. Moreover, recent studies have shown the value of supraclavicular lymph nodes irradiation, even with only one positive axillar lymph node. Since a portion of the thyroid gland may also be included in the treatment fields, hypothyroidism, which has already been described as a well-known phenomenon following irradiation for Hodgkin's disease and head and neck tumors, should be considered a potential late complication of breast cancer radiotherapy. In one of the few studies found in literature, Reinertsen observed the prevalence of 18% of hypothyroidism in 403 patients submitted to breast radiotherapy, compared to 6% in the general population. The total dose received by the gland may play a major role in the incidence of hypothyroidism. Constin found hypothyroidism in 17% of children who received doses below 26 Gy to the thyroid, compared to 78% who received more than 26 Gy, in a study of children treated for group treated for Hodgkin's disease. Eighteen women eligible for breast and supraclavicular radiation were evaluated in order to quantify the absorbed dose of the thyroid parenchyma. Three lithium fluoride TLD-100 thermoluminescent dosimeters (TLDs) measuring 3 mm x 3 mm x 1 mm were used for dose measurement and positioned on the right and left lobes and the isthmus, and each patient was submitted to three measurements. The treatment planning was based on transverse CT images using a commercial treatment planning system, consisting in a field arrangement of an anterior supraclavicular and two tangential fields. The cranial supraclavicular edge of the target volume was 1 cm below the larynx, whereas the medial edge was defined 1 cm lateral to the trachea down to the sternoclavicular junction. Photons of 6 MV were used for all treatment fields, and 50 Gy in 25 fractions were prescribed at 3cm depth. The mean maximum dose observed in the entire gland was 605cGy, varying between 2.48% and 35% of the prescribed dose. The ipsilateral and the contralateral thyroid lobe, as well as the isthmus received a mean dose of 593cGy, 296cGy and 249cGy respectively, which corresponds to 11.8%, 5.9% and 4.9% of the prescribed dose. Despite the fact that the measured values were below the total dose of 26 Gy, the thyroid gland dose was higher than expected, in some cases reaching almost 35% of the prescribed dose. Hypothyroidism following breast radiotherapy could be an underestimated complication, hence the importance of monitoring the function of the thyroid gland in these patients." @default.
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- W2000997424 date "2010-11-01" @default.
- W2000997424 modified "2023-10-17" @default.
- W2000997424 title "In Vivo Dosimetry Analysis of Thyroid Gland Dose in Breast Cancer Patients with Supraclavicular Lymph Node Irradiation" @default.
- W2000997424 doi "https://doi.org/10.1016/j.ijrobp.2010.07.1660" @default.
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