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      Dosimetric Advantages of the Field-in-field Plan Compared with the Tangential Wedged Beams Plan for Whole-breast Irradiation = 유방암 환자의 방사선치료에 있어서 순치료계획 세기변조방사선치료법과 쐐기접선조사기법의 선량측정 비교

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      https://www.riss.kr/link?id=A100841572

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      다국어 초록 (Multilingual Abstract)

      The purpose of this study is to evaluate the dosimetric outcome of the field-in-field (FIF) plans compared with tangential wedged beams (TWB) plans for whole breast irradiation of breast cancer patients. Twenty patients with right-sided breast cancer and 10 patients with left-sided breast cancer were retrospectively enrolled in this study. We generated a FIF plan and a TWB plan for each patient to compare dosimetric outcomes. The dose the homogeneity index (HI), the conformity index (CI) and the uniformity index (UI) were defined and used for comparison of the dosimetric outcome of the planning target volume (PTV). To compare the dosimetric outcome of the organs at risk, the mean dose ($D_{mean}$) and the percentage of volumes receiving more than 10, 20 and 30 Gy of the ipsilateral lung and heart were used. The FIF plans had significantly lower HI (p=0.002), higher UI (p=0.000) and CI (p=0.000) than those of the TWB plans, which means that the FIF plans were better than the TWB plans in the dosimetric comparisons of the PTV. The $V10_{lung}$ ($17.1{\pm}7.1$ vs. $18.6{\pm}6.6%$, p=0.020) and $V30_{lung}$ ($10.3{\pm}5.1%$ vs. $10.7{\pm}5.2%$, p=0.000) were lower with the FIF plans compared with those of the TWB plans, with statistical significance. For the left-sided breast cancer patients, $D_{mean}$ of the heart ($2.6{\pm}1.3$ vs. $3.2{\pm}1.4$ Gy, p=0.000), $V20_{heart}$ ($3.4{\pm}2.6$ vs. $3.6{\pm}2.8%$, p=0.005) and $V30_{heart}$ ($2.6{\pm}2.3%$ vs. $2.9{\pm}2.4%$, p=0.004) were significantly lower for the FIF plans in comparison with those of the TWB plans. The FIF plans increased the dose homogeneity, conformity and uniformity of the target volume for the whole-breast irradiation compared with the TWB plans. Moreover, FIF plans reduced the doses to the ipsilateral lung and heart.
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      The purpose of this study is to evaluate the dosimetric outcome of the field-in-field (FIF) plans compared with tangential wedged beams (TWB) plans for whole breast irradiation of breast cancer patients. Twenty patients with right-sided breast cancer ...

      The purpose of this study is to evaluate the dosimetric outcome of the field-in-field (FIF) plans compared with tangential wedged beams (TWB) plans for whole breast irradiation of breast cancer patients. Twenty patients with right-sided breast cancer and 10 patients with left-sided breast cancer were retrospectively enrolled in this study. We generated a FIF plan and a TWB plan for each patient to compare dosimetric outcomes. The dose the homogeneity index (HI), the conformity index (CI) and the uniformity index (UI) were defined and used for comparison of the dosimetric outcome of the planning target volume (PTV). To compare the dosimetric outcome of the organs at risk, the mean dose ($D_{mean}$) and the percentage of volumes receiving more than 10, 20 and 30 Gy of the ipsilateral lung and heart were used. The FIF plans had significantly lower HI (p=0.002), higher UI (p=0.000) and CI (p=0.000) than those of the TWB plans, which means that the FIF plans were better than the TWB plans in the dosimetric comparisons of the PTV. The $V10_{lung}$ ($17.1{\pm}7.1$ vs. $18.6{\pm}6.6%$, p=0.020) and $V30_{lung}$ ($10.3{\pm}5.1%$ vs. $10.7{\pm}5.2%$, p=0.000) were lower with the FIF plans compared with those of the TWB plans, with statistical significance. For the left-sided breast cancer patients, $D_{mean}$ of the heart ($2.6{\pm}1.3$ vs. $3.2{\pm}1.4$ Gy, p=0.000), $V20_{heart}$ ($3.4{\pm}2.6$ vs. $3.6{\pm}2.8%$, p=0.005) and $V30_{heart}$ ($2.6{\pm}2.3%$ vs. $2.9{\pm}2.4%$, p=0.004) were significantly lower for the FIF plans in comparison with those of the TWB plans. The FIF plans increased the dose homogeneity, conformity and uniformity of the target volume for the whole-breast irradiation compared with the TWB plans. Moreover, FIF plans reduced the doses to the ipsilateral lung and heart.

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      참고문헌 (Reference)

      1 Fisher B, "Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer" 347 : 1233-1241, 2002

      2 Solin LJ, "Three-dimensional photon treatment planning of the intact breast" 21 : 193-203, 1991

      3 김지선, "The Basic Facts of Korean Breast Cancer in 2011: Results of a Nationwide Survey and Breast Cancer Registry Database" 한국유방암학회 17 (17): 99-106, 2014

      4 Darby SC, "Risk of ischemic heart disease in women after radiotherapy for breast cancer" 368 : 987-998, 2013

      5 Mukesh MB, "Randomized controlled trial of intensity-modulated radiotherapy for early breast cancer: 5-year results confirm superior overall cosmesis" 31 : 4488-4495, 2013

      6 Marks LB, "Radiation-induced lung injury" 13 : 333-345, 2003

      7 Blom Goldman U, "Radiation pneumonitis and pulmonary function with lung dosevolume constraints in breast cancer irradiation" 13 : 211-217, 2014

      8 Zhang XJ, "Prediction of radiation pneumonitis in lung cancer patients: a systemic review" 138 : 2103-2116, 2012

      9 Harris EE, "Late cardiac mortality and morbidity in early-stage breast cancer patients after breast conservation treatment" 24 : 4100-4106, 2006

      10 Sun LM, "Field-in-field plan does not improve dosimetric outcome compared with the wedged beams plan for breast cancer radiotherapy" 39 : 79-82, 2014

      1 Fisher B, "Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer" 347 : 1233-1241, 2002

      2 Solin LJ, "Three-dimensional photon treatment planning of the intact breast" 21 : 193-203, 1991

      3 김지선, "The Basic Facts of Korean Breast Cancer in 2011: Results of a Nationwide Survey and Breast Cancer Registry Database" 한국유방암학회 17 (17): 99-106, 2014

      4 Darby SC, "Risk of ischemic heart disease in women after radiotherapy for breast cancer" 368 : 987-998, 2013

      5 Mukesh MB, "Randomized controlled trial of intensity-modulated radiotherapy for early breast cancer: 5-year results confirm superior overall cosmesis" 31 : 4488-4495, 2013

      6 Marks LB, "Radiation-induced lung injury" 13 : 333-345, 2003

      7 Blom Goldman U, "Radiation pneumonitis and pulmonary function with lung dosevolume constraints in breast cancer irradiation" 13 : 211-217, 2014

      8 Zhang XJ, "Prediction of radiation pneumonitis in lung cancer patients: a systemic review" 138 : 2103-2116, 2012

      9 Harris EE, "Late cardiac mortality and morbidity in early-stage breast cancer patients after breast conservation treatment" 24 : 4100-4106, 2006

      10 Sun LM, "Field-in-field plan does not improve dosimetric outcome compared with the wedged beams plan for breast cancer radiotherapy" 39 : 79-82, 2014

      11 Clarke M, "Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomized trials" 17 : 2087-2106, 2005

      12 Sasaoka M, "Dosimetric evaluation of whole breast radiotherapy using field-in-field technique in early-stage breast cancer" 16 : 250-256, 2011

      13 Onal C, "Dosimetric comparison of the field-in-field technique and tangential wedged beams for breast irradiation" 30 : 218-226, 2012

      14 Buchholz TA, "Dosimetric analysis of intact breast irradiation in off-axis planes" 39 : 261-267, 1997

      15 Graham MV, "Clinical dose-volume histogram analysis for pneumonitis after 3D treatment for non-small cell lung cancer (NSCLC)" 45 : 323-329, 1999

      16 Borger JH, "Cardiotoxic effects of tangential breast irradiation in early breast cancer patients:the role of irradiated heart volume" 69 : 1131-1138, 2007

      17 Rapiti E, "Breast-conserving surgery has equivalent effect as mastectomy on stage I breast cancer prognosis only when followed by radiotherapy" 69 : 277-284, 2003

      18 Barnett GC, "A randomized controlled trial of forward-planned radiotherapy (IMRT) for early breast cancer: Baseline characteristics and dosimetry results" 92 : 34-41, 2009

      19 Claude L, "A prospective study on radiation pneumonitis following conformal radiation therapy in non-small cell lung cancer" 71 : 175-181, 2004

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