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• W4230430129 abstract "We have previously reported that most of axillary lymph node regions could be irradiated by the modified tangential irradiation technique (MTIT) in the IJROBP 2000 and 2004. The purpose of this study was to determine whether the use of three-dimensional conformal radiotherapy (3D-CRT) with a field-in-field technique improves dosimetry for the breast and axillary lymph nodes. Fifty patients with left-sided breast cancer were enrolled. The clinical target volume included the left breast and level I to II axillary nodes. With MTIT, we planned the radiation field size to be wider in the cranial direction than in the standard tangential fields in order to include the axillary regions. In planning with 3D-CRT, the multi-leaf collimator (MLC) was used to shape the planned target volume, using gantry angles similar to those of MTIT. Furthermore, the heart and contralateral breast were spared to the extent possible by applying the MLC manually. For hot regions receiving a dose >107% of the prescribed dose, a field-in-field technique was used to reduce dosage inhomogeneity. Dose-volume histograms were compared for the breast, axillary nodal region, heart, lung, and other normal tissues such as the skin and soft tissues. There were no significant differences in the percent volume of the breast receiving more than 90% of the prescribed dose (V90) between MTIT and 3D-CRT. The mean V90 of the level I to III axillary regions were increased from 93.7%, 48.2%, and 41.3% with MTIT to 97.6%, 85.8%, and 82.8% with 3D-CRT (all p < 0.01). The V107 of the breast and axillary region were significantly lower with 3D-CRT than with MTIT. The 3D-CRT plan significantly reduced the volume of the heart receiving more than 30 Gy (mean, 7.6 ml vs. 15.9 ml; p < 0.01), the percent volume of the bilateral lung receiving more than 20 Gy (7.4% vs. 8.9%; p < 0.01), and the volume of other normal tissues receiving more than 107% of the prescribed dose (0.1 ml vs. 2.9 ml; p < 0.01). The use of 3D-CRT with a field-in-field technique improves regional node coverage, while decreasing doses to the heart, lungs, and the other normal tissues, as compared with MTIT." @default.
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• W4230430129 date "2008-09-01" @default.
• W4230430129 modified "2023-09-26" @default.
• W4230430129 title "Dose Distribution Analysis of Axillary Lymph Nodes for Three-dimensional Conformal Radiotherapy with a Field-in-field Technique for Breast Cancer" @default.
• W4230430129 doi "https://doi.org/10.1016/j.ijrobp.2008.06.736" @default.
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