Evaluation of novel modified tangential irradiation technique for breast cancer patients using dose-volume histograms

Atsuya Takeda, Naoyuki Shigematsu, Tadashi Ikeda, Osamu Kawaguchi, Shoji Kutsuki, Ryochi Ishibashi, Etsuo Kunieda, Toshiaki Takeda, Kazuhiko Takemasa, Hisao Ito, Takashi Uno, Hiromitsu Jinno, Atsushi Kubo

研究成果: Article

20 引用 (Scopus)

抄録

Purpose We have previously reported that entire axillary lymph node regions could be irradiated by the modified tangential irradiation technique (MTIT). In this study, MTIT was compared with a conventional irradiation technique (CTIT) using dose-volume histograms to verify how adequately MTIT covers the breast and axillary lymph node region and the extent to which it involves the lung and heart. Methods and materials Forty-four patients with early-stage breast cancer were treated by lumpectomy, axillary dissection, and postoperative radiotherapy. Twenty-two patients were treated with MTIT and 22 with CTIT. In 25 patients, the breast tumor was on the left and in 19 on the right. During axillary dissection, surgical clips were left as markers at the border of the axillary lymph node region. MTIT was planned by setting the dorsal edge of the radiation field on a lateral-view simulator film at the dorsal edge of the humeral head and the cranial edge of the radiation field at the caudal edge of the humeral head. CTIT was planned to ensure radiation of the breast tissue without considering the axillary region. In this study, all patients underwent computed tomography, and the CT data were transmitted on-line to a radiotherapy planning system, in which the dose-distribution computed tomography images and dose-volume histograms were calculated by defining the breast, axillary region (levels I, II, and III), lung, and heart region. Results Dose-volume histogram analysis demonstrated that breast tissue was radiated with an 86.5-100% volume (median 96.5%) by MTIT and an 83-100% volume (median, 95%) by CTIT at >95% of the isocenter dose. The axillary lymph node regions at Levels I, II, and III were irradiated with 84-100% (median, 94.5%), 59-100% (median, 89%), and 70-100% (median, 89.5%) volumes, respectively, by MTIT and with 2-84% (median, 38%), 0-53% (median, 15%), and 0-31% (median, 0%) volumes, respectively, by CTIT at >70% of the isocenter dose. The ipsilateral lung was irradiated with a 5-22% volume (median, 11.5%) by MTIT and 5-15% volume (median 9%) by CTIT at >90% of the isocenter dose. In all 25 left-sided breast cancer patients, the volumes irradiated with an 80% isocenter dose were <30 cm3. Conclusion The results of our study demonstrated that the breast tissue was sufficiently irradiated with both CTIT and MTIT planning, the axillary lymph node areas irradiated by MTIT were much wider than those irradiated by CTIT at all levels, and the lung and heart volumes irradiated by MTIT were small.

元の言語English
ページ(範囲)1280-1288
ページ数9
ジャーナルInternational Journal of Radiation Oncology Biology Physics
58
発行部数4
DOI
出版物ステータスPublished - 2004 3 15

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histograms
breast
Breast
Lymph Nodes
cancer
Breast Neoplasms
dosage
irradiation
evaluation
Humeral Head
Lung
Radiation
Dissection
Radiotherapy
lymphatic system
Tomography
Planning Techniques
Cardiac Volume
Segmental Mastectomy
Motion Pictures

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

これを引用

Evaluation of novel modified tangential irradiation technique for breast cancer patients using dose-volume histograms. / Takeda, Atsuya; Shigematsu, Naoyuki; Ikeda, Tadashi; Kawaguchi, Osamu; Kutsuki, Shoji; Ishibashi, Ryochi; Kunieda, Etsuo; Takeda, Toshiaki; Takemasa, Kazuhiko; Ito, Hisao; Uno, Takashi; Jinno, Hiromitsu; Kubo, Atsushi.

:: International Journal of Radiation Oncology Biology Physics, 巻 58, 番号 4, 15.03.2004, p. 1280-1288.

研究成果: Article

Takeda, A, Shigematsu, N, Ikeda, T, Kawaguchi, O, Kutsuki, S, Ishibashi, R, Kunieda, E, Takeda, T, Takemasa, K, Ito, H, Uno, T, Jinno, H & Kubo, A 2004, 'Evaluation of novel modified tangential irradiation technique for breast cancer patients using dose-volume histograms', International Journal of Radiation Oncology Biology Physics, 巻. 58, 番号 4, pp. 1280-1288. https://doi.org/10.1016/j.ijrobp.2003.10.010
Takeda, Atsuya ; Shigematsu, Naoyuki ; Ikeda, Tadashi ; Kawaguchi, Osamu ; Kutsuki, Shoji ; Ishibashi, Ryochi ; Kunieda, Etsuo ; Takeda, Toshiaki ; Takemasa, Kazuhiko ; Ito, Hisao ; Uno, Takashi ; Jinno, Hiromitsu ; Kubo, Atsushi. / Evaluation of novel modified tangential irradiation technique for breast cancer patients using dose-volume histograms. :: International Journal of Radiation Oncology Biology Physics. 2004 ; 巻 58, 番号 4. pp. 1280-1288.
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abstract = "Purpose We have previously reported that entire axillary lymph node regions could be irradiated by the modified tangential irradiation technique (MTIT). In this study, MTIT was compared with a conventional irradiation technique (CTIT) using dose-volume histograms to verify how adequately MTIT covers the breast and axillary lymph node region and the extent to which it involves the lung and heart. Methods and materials Forty-four patients with early-stage breast cancer were treated by lumpectomy, axillary dissection, and postoperative radiotherapy. Twenty-two patients were treated with MTIT and 22 with CTIT. In 25 patients, the breast tumor was on the left and in 19 on the right. During axillary dissection, surgical clips were left as markers at the border of the axillary lymph node region. MTIT was planned by setting the dorsal edge of the radiation field on a lateral-view simulator film at the dorsal edge of the humeral head and the cranial edge of the radiation field at the caudal edge of the humeral head. CTIT was planned to ensure radiation of the breast tissue without considering the axillary region. In this study, all patients underwent computed tomography, and the CT data were transmitted on-line to a radiotherapy planning system, in which the dose-distribution computed tomography images and dose-volume histograms were calculated by defining the breast, axillary region (levels I, II, and III), lung, and heart region. Results Dose-volume histogram analysis demonstrated that breast tissue was radiated with an 86.5-100{\%} volume (median 96.5{\%}) by MTIT and an 83-100{\%} volume (median, 95{\%}) by CTIT at >95{\%} of the isocenter dose. The axillary lymph node regions at Levels I, II, and III were irradiated with 84-100{\%} (median, 94.5{\%}), 59-100{\%} (median, 89{\%}), and 70-100{\%} (median, 89.5{\%}) volumes, respectively, by MTIT and with 2-84{\%} (median, 38{\%}), 0-53{\%} (median, 15{\%}), and 0-31{\%} (median, 0{\%}) volumes, respectively, by CTIT at >70{\%} of the isocenter dose. The ipsilateral lung was irradiated with a 5-22{\%} volume (median, 11.5{\%}) by MTIT and 5-15{\%} volume (median 9{\%}) by CTIT at >90{\%} of the isocenter dose. In all 25 left-sided breast cancer patients, the volumes irradiated with an 80{\%} isocenter dose were <30 cm3. Conclusion The results of our study demonstrated that the breast tissue was sufficiently irradiated with both CTIT and MTIT planning, the axillary lymph node areas irradiated by MTIT were much wider than those irradiated by CTIT at all levels, and the lung and heart volumes irradiated by MTIT were small.",
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author = "Atsuya Takeda and Naoyuki Shigematsu and Tadashi Ikeda and Osamu Kawaguchi and Shoji Kutsuki and Ryochi Ishibashi and Etsuo Kunieda and Toshiaki Takeda and Kazuhiko Takemasa and Hisao Ito and Takashi Uno and Hiromitsu Jinno and Atsushi Kubo",
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TY - JOUR

T1 - Evaluation of novel modified tangential irradiation technique for breast cancer patients using dose-volume histograms

AU - Takeda, Atsuya

AU - Shigematsu, Naoyuki

AU - Ikeda, Tadashi

AU - Kawaguchi, Osamu

AU - Kutsuki, Shoji

AU - Ishibashi, Ryochi

AU - Kunieda, Etsuo

AU - Takeda, Toshiaki

AU - Takemasa, Kazuhiko

AU - Ito, Hisao

AU - Uno, Takashi

AU - Jinno, Hiromitsu

AU - Kubo, Atsushi

PY - 2004/3/15

Y1 - 2004/3/15

N2 - Purpose We have previously reported that entire axillary lymph node regions could be irradiated by the modified tangential irradiation technique (MTIT). In this study, MTIT was compared with a conventional irradiation technique (CTIT) using dose-volume histograms to verify how adequately MTIT covers the breast and axillary lymph node region and the extent to which it involves the lung and heart. Methods and materials Forty-four patients with early-stage breast cancer were treated by lumpectomy, axillary dissection, and postoperative radiotherapy. Twenty-two patients were treated with MTIT and 22 with CTIT. In 25 patients, the breast tumor was on the left and in 19 on the right. During axillary dissection, surgical clips were left as markers at the border of the axillary lymph node region. MTIT was planned by setting the dorsal edge of the radiation field on a lateral-view simulator film at the dorsal edge of the humeral head and the cranial edge of the radiation field at the caudal edge of the humeral head. CTIT was planned to ensure radiation of the breast tissue without considering the axillary region. In this study, all patients underwent computed tomography, and the CT data were transmitted on-line to a radiotherapy planning system, in which the dose-distribution computed tomography images and dose-volume histograms were calculated by defining the breast, axillary region (levels I, II, and III), lung, and heart region. Results Dose-volume histogram analysis demonstrated that breast tissue was radiated with an 86.5-100% volume (median 96.5%) by MTIT and an 83-100% volume (median, 95%) by CTIT at >95% of the isocenter dose. The axillary lymph node regions at Levels I, II, and III were irradiated with 84-100% (median, 94.5%), 59-100% (median, 89%), and 70-100% (median, 89.5%) volumes, respectively, by MTIT and with 2-84% (median, 38%), 0-53% (median, 15%), and 0-31% (median, 0%) volumes, respectively, by CTIT at >70% of the isocenter dose. The ipsilateral lung was irradiated with a 5-22% volume (median, 11.5%) by MTIT and 5-15% volume (median 9%) by CTIT at >90% of the isocenter dose. In all 25 left-sided breast cancer patients, the volumes irradiated with an 80% isocenter dose were <30 cm3. Conclusion The results of our study demonstrated that the breast tissue was sufficiently irradiated with both CTIT and MTIT planning, the axillary lymph node areas irradiated by MTIT were much wider than those irradiated by CTIT at all levels, and the lung and heart volumes irradiated by MTIT were small.

AB - Purpose We have previously reported that entire axillary lymph node regions could be irradiated by the modified tangential irradiation technique (MTIT). In this study, MTIT was compared with a conventional irradiation technique (CTIT) using dose-volume histograms to verify how adequately MTIT covers the breast and axillary lymph node region and the extent to which it involves the lung and heart. Methods and materials Forty-four patients with early-stage breast cancer were treated by lumpectomy, axillary dissection, and postoperative radiotherapy. Twenty-two patients were treated with MTIT and 22 with CTIT. In 25 patients, the breast tumor was on the left and in 19 on the right. During axillary dissection, surgical clips were left as markers at the border of the axillary lymph node region. MTIT was planned by setting the dorsal edge of the radiation field on a lateral-view simulator film at the dorsal edge of the humeral head and the cranial edge of the radiation field at the caudal edge of the humeral head. CTIT was planned to ensure radiation of the breast tissue without considering the axillary region. In this study, all patients underwent computed tomography, and the CT data were transmitted on-line to a radiotherapy planning system, in which the dose-distribution computed tomography images and dose-volume histograms were calculated by defining the breast, axillary region (levels I, II, and III), lung, and heart region. Results Dose-volume histogram analysis demonstrated that breast tissue was radiated with an 86.5-100% volume (median 96.5%) by MTIT and an 83-100% volume (median, 95%) by CTIT at >95% of the isocenter dose. The axillary lymph node regions at Levels I, II, and III were irradiated with 84-100% (median, 94.5%), 59-100% (median, 89%), and 70-100% (median, 89.5%) volumes, respectively, by MTIT and with 2-84% (median, 38%), 0-53% (median, 15%), and 0-31% (median, 0%) volumes, respectively, by CTIT at >70% of the isocenter dose. The ipsilateral lung was irradiated with a 5-22% volume (median, 11.5%) by MTIT and 5-15% volume (median 9%) by CTIT at >90% of the isocenter dose. In all 25 left-sided breast cancer patients, the volumes irradiated with an 80% isocenter dose were <30 cm3. Conclusion The results of our study demonstrated that the breast tissue was sufficiently irradiated with both CTIT and MTIT planning, the axillary lymph node areas irradiated by MTIT were much wider than those irradiated by CTIT at all levels, and the lung and heart volumes irradiated by MTIT were small.

KW - Axillary lymph nodes

KW - Breast cancer

KW - Dose-volume histogram analysis

KW - Modified tangential irradiation technique

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