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摘要
The purpose of this study was to compare the dosimetric parameters for incidental irradiation to the axilla during whole breast radiotherapy (WBRT) with 3-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT). Twenty left breast cancer patients treated with WBRT after breast-conserving surgery (BCS) were enrolled in this study. Remnant breast tissue, 3 levels of the axilla, heart, and lung were delineated. We used 2 different radiotherapy methods: 3D-CRT with field-in-field technique and 7-field fixed-beam IMRT. The target coverage of IMRT was significantly better than that of 3D-CRT (D-mean: 49.72 +/- 0.64 Gy vs 50.24 +/- 0.66 Gy, P<0.001; V-45: 93.19 +/- 1.40% vs 98.59 +/- 0.30%, P<0.001; V-47.5: 86.43 +/- 2.72% vs 95.00 +/- 0.02%, P<0.001, for 3D-CRT and IMRT, respectively). In the IMRT plan, a lower dose was delivered to a wider region of the heart and lung. Significantly lower axillary irradiation was shown throughout each level of axilla by IMRT compared to 3D-CRT (D-mean for level I: 42.58 +/- 5.31 Gy vs 14.49 +/- 6.91 Gy, P<0.001; D-mean for level II: 26.25 +/- 10.43 Gy vs 3.41 +/- 3.11 Gy, P<0.001; D-mean for level III: 6.26 +/- 4.69 Gy vs 1.16 +/- 0.51 Gy, P<0.001; D-mean for total axilla: 33.9 +/- 6.89 Gy vs 9.96 +/- 5.21 Gy, P<0.001, for 3D-CRT and IMRT, respectively). In conclusion, the incidental dose delivered to the axilla was significantly lower for IMRT compared to 3D-CRT. Therefore, IMRT, which only includes the breast parenchyma, should be cautiously used in patients with limited positive sentinel lymph nodes and who do not undergo complete axillary lymph node dissection.
- 出版日期2016-6
