Axillary irradiation with high tangent fields for clinically node-negative breast cancer

Can 3-d conformal radiotherapy with a field-in-field technique better control the axilla?

Naoko Sanuki, Atsuya Takeda, Atsushi Amemiya, Toru Ofuchi, Masato Ono, Haruki Ogata, Ryo Yamagami, Jun Hatayama, Takahisa Eriguchi, Etsuo Kunieda

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: The target volume for postoperative breast irradiation is the remaining breast tissue, and the axillary region is not an intentional target volume. Patients and Methods: Between 2001 and 2009, eligible women with pT1-2cN0/pN0(sn) breast cancer underwent breast-conserving therapy without axillary dissection. Treatment outcomes between 2 radiotherapy planning groups, high tangent fields with 2-dimensional (2-D) simulation-based planning and 3-dimensional (3-D) computed tomography-based planning with a field-in-field technique, were compared. The correlating factors for axillary failure were also calculated. Results: In total, 678 patients were eligible. As of May 2009, the median follow-up times for the 2-D (n = 346) and 3-D (n = 332) groups were 94 and 52 months, respectively. Patient characteristics were balanced, except for a younger population in the 2-D group and more lymphovascular invasion in the 3-D group. On multivariate analysis, 2-D planning was the only risk factor for axillary failure. In the 2-D and 3-D groups, the 5-year cumulative incidences of axillary failure were 8 (3.1%) and 1 (0.3%) (log-rank p = 0.009), respectively. The respective 5-year overall survival rates were 97.4 and 98.4% (p = 0.4). Conclusion: High tangent irradiation with 3-D planning improved axillary control compared to that with 2-D planning, suggesting that optimizing axillary dose distribution may impact outcomes.

Original languageEnglish
Pages (from-to)362-367
Number of pages6
JournalBreast Care
Volume8
Issue number5
DOIs
Publication statusPublished - 2013 Oct
Externally publishedYes

Fingerprint

Conformal Radiotherapy
Axilla
Breast
Breast Neoplasms
Dissection
Radiotherapy
Multivariate Analysis
Survival Rate
Tomography
Incidence
Population
Breast Cancer 3
Therapeutics

Keywords

  • Breast cancer
  • Conformal radiotherapy
  • Sentinel lymph node biopsy

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Axillary irradiation with high tangent fields for clinically node-negative breast cancer : Can 3-d conformal radiotherapy with a field-in-field technique better control the axilla? / Sanuki, Naoko; Takeda, Atsuya; Amemiya, Atsushi; Ofuchi, Toru; Ono, Masato; Ogata, Haruki; Yamagami, Ryo; Hatayama, Jun; Eriguchi, Takahisa; Kunieda, Etsuo.

In: Breast Care, Vol. 8, No. 5, 10.2013, p. 362-367.

Research output: Contribution to journalArticle

Sanuki, N, Takeda, A, Amemiya, A, Ofuchi, T, Ono, M, Ogata, H, Yamagami, R, Hatayama, J, Eriguchi, T & Kunieda, E 2013, 'Axillary irradiation with high tangent fields for clinically node-negative breast cancer: Can 3-d conformal radiotherapy with a field-in-field technique better control the axilla?', Breast Care, vol. 8, no. 5, pp. 362-367. https://doi.org/10.1159/000355708
Sanuki, Naoko ; Takeda, Atsuya ; Amemiya, Atsushi ; Ofuchi, Toru ; Ono, Masato ; Ogata, Haruki ; Yamagami, Ryo ; Hatayama, Jun ; Eriguchi, Takahisa ; Kunieda, Etsuo. / Axillary irradiation with high tangent fields for clinically node-negative breast cancer : Can 3-d conformal radiotherapy with a field-in-field technique better control the axilla?. In: Breast Care. 2013 ; Vol. 8, No. 5. pp. 362-367.
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abstract = "Background: The target volume for postoperative breast irradiation is the remaining breast tissue, and the axillary region is not an intentional target volume. Patients and Methods: Between 2001 and 2009, eligible women with pT1-2cN0/pN0(sn) breast cancer underwent breast-conserving therapy without axillary dissection. Treatment outcomes between 2 radiotherapy planning groups, high tangent fields with 2-dimensional (2-D) simulation-based planning and 3-dimensional (3-D) computed tomography-based planning with a field-in-field technique, were compared. The correlating factors for axillary failure were also calculated. Results: In total, 678 patients were eligible. As of May 2009, the median follow-up times for the 2-D (n = 346) and 3-D (n = 332) groups were 94 and 52 months, respectively. Patient characteristics were balanced, except for a younger population in the 2-D group and more lymphovascular invasion in the 3-D group. On multivariate analysis, 2-D planning was the only risk factor for axillary failure. In the 2-D and 3-D groups, the 5-year cumulative incidences of axillary failure were 8 (3.1{\%}) and 1 (0.3{\%}) (log-rank p = 0.009), respectively. The respective 5-year overall survival rates were 97.4 and 98.4{\%} (p = 0.4). Conclusion: High tangent irradiation with 3-D planning improved axillary control compared to that with 2-D planning, suggesting that optimizing axillary dose distribution may impact outcomes.",
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AU - Amemiya, Atsushi

AU - Ofuchi, Toru

AU - Ono, Masato

AU - Ogata, Haruki

AU - Yamagami, Ryo

AU - Hatayama, Jun

AU - Eriguchi, Takahisa

AU - Kunieda, Etsuo

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N2 - Background: The target volume for postoperative breast irradiation is the remaining breast tissue, and the axillary region is not an intentional target volume. Patients and Methods: Between 2001 and 2009, eligible women with pT1-2cN0/pN0(sn) breast cancer underwent breast-conserving therapy without axillary dissection. Treatment outcomes between 2 radiotherapy planning groups, high tangent fields with 2-dimensional (2-D) simulation-based planning and 3-dimensional (3-D) computed tomography-based planning with a field-in-field technique, were compared. The correlating factors for axillary failure were also calculated. Results: In total, 678 patients were eligible. As of May 2009, the median follow-up times for the 2-D (n = 346) and 3-D (n = 332) groups were 94 and 52 months, respectively. Patient characteristics were balanced, except for a younger population in the 2-D group and more lymphovascular invasion in the 3-D group. On multivariate analysis, 2-D planning was the only risk factor for axillary failure. In the 2-D and 3-D groups, the 5-year cumulative incidences of axillary failure were 8 (3.1%) and 1 (0.3%) (log-rank p = 0.009), respectively. The respective 5-year overall survival rates were 97.4 and 98.4% (p = 0.4). Conclusion: High tangent irradiation with 3-D planning improved axillary control compared to that with 2-D planning, suggesting that optimizing axillary dose distribution may impact outcomes.

AB - Background: The target volume for postoperative breast irradiation is the remaining breast tissue, and the axillary region is not an intentional target volume. Patients and Methods: Between 2001 and 2009, eligible women with pT1-2cN0/pN0(sn) breast cancer underwent breast-conserving therapy without axillary dissection. Treatment outcomes between 2 radiotherapy planning groups, high tangent fields with 2-dimensional (2-D) simulation-based planning and 3-dimensional (3-D) computed tomography-based planning with a field-in-field technique, were compared. The correlating factors for axillary failure were also calculated. Results: In total, 678 patients were eligible. As of May 2009, the median follow-up times for the 2-D (n = 346) and 3-D (n = 332) groups were 94 and 52 months, respectively. Patient characteristics were balanced, except for a younger population in the 2-D group and more lymphovascular invasion in the 3-D group. On multivariate analysis, 2-D planning was the only risk factor for axillary failure. In the 2-D and 3-D groups, the 5-year cumulative incidences of axillary failure were 8 (3.1%) and 1 (0.3%) (log-rank p = 0.009), respectively. The respective 5-year overall survival rates were 97.4 and 98.4% (p = 0.4). Conclusion: High tangent irradiation with 3-D planning improved axillary control compared to that with 2-D planning, suggesting that optimizing axillary dose distribution may impact outcomes.

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