| HONG Wei,RAN Li,LU Bing,et al.Dosimetry of different techniques in postmastectomy radiation therapy on the ipsilateral lung[J].Chinese Journal of Radiological Medicine and Protection,2011,31(6):684-687 |
| Dosimetry of different techniques in postmastectomy radiation therapy on the ipsilateral lung |
| Received:January 28, 2011 |
| DOI：10.3760/cma.j.issn.0254-5098.2011.06.016 |
| KeyWords:Postmastectomy Radiation therapy Ipsilateral lung dose Dosimetry |
| FundProject: |
| Author Name | Affiliation | | HONG Wei | Department of Radiation Oncology, Guizhou Province Cancer Hospital, Guiyang 550004, China | | RAN Li | Department of Radiation Oncology, Guizhou Province Cancer Hospital, Guiyang 550004, China | | LU Bing | Department of Radiation Oncology, Guizhou Province Cancer Hospital, Guiyang 550004, China | | YANG Li | Department of Radiation Oncology, Guizhou Province Cancer Hospital, Guiyang 550004, China | | CHANG Jian-ying | Department of Radiation Oncology, Guizhou Province Cancer Hospital, Guiyang 550004, China | | GAN Jia-ying | Department of Radiation Oncology, Guizhou Province Cancer Hospital, Guiyang 550004, China | | HU Yin-xiang | Department of Radiation Oncology, Guizhou Province Cancer Hospital, Guiyang 550004, China |
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| Abstract:: |
| Objective To identify the best technique of postmastectomy radiation therapy (PMRT). Methods Twenty-eight patients with stage Ⅱ or Ⅲ invasive breast cancer were treated with modified radical mastectomy and radiotherapy sequaciously involving the supraclavicular region and the chest wall. Three different techniques were developed for each patient: two tangential conformal fields (half field) in the chest wall plus supraclavicular intensity modulated radiotherapy (3D-CRT+IMRT), integrated chest wall and supraclavicular IMRT(IMRT), and two tangential conformal fields (half field) in the chest wall plus single field electron beam radiotherapy in the supraclavicular region(3D-CRT+E). The dose distributions of the target areas and the irradiated volumes of the ipsilateral lung (V5,V10,V20, and V45)were estimated with the dosage volume histogram(DVH). The dosage prescription was 50.4 Gy (1.8 Gy × 28 f). Results The conformity index (CI) of the 3D-CRT+IMRT group was (0.61±0.03), not different from that of the IMRT [(0.62±0.03), q=2.16, P>0.05], and the CI levels of these 2 groups were both higher than that of the 3D-CRT+E group [(0.44±0.02), q=20.50, 22.66,P<0.01]. The heterogeneity index (HI) of the 3D-CRT+IMRT group was (1.17±0.02), not different from that of the IMRT [(1.15±0.02), q=1.66, P>0.05], and the HI levels of these 2 groups were both lower than that of the 3D-CRT+E group[(1.24±0.04), q=3.91, 5.58, P<0.01]. The levels of V5 and V10of the ipsilateral lungs of the 3D-CRT+E group(48.70%±3.24%, 38%.56%±3.70%) and 3D-CRT+IMRT group (49.12%±3.03%,38.38%±3.56%) were all significantly lower than those of the IMRT group [(77.18%±8.01%, 53.07%±6.85%),V5,q=20.35, 20.05, P<0.01; V10,q=12.10, 12.24, P<0.01] and there were not significant differences in the V5 and V10 levels between the 3D-CRT+E and 3D-CRT+IMRT groups (q=0.30, 0.14, P＞0.05). The levels of V20of the ipsilateral lungs of the 3D-CRT+IMRT group (26.57%±2.51%)and IMRT group (25.22%±2.77%) were all significantly lower that those of the 3D-CRT+E group [(31.79%±3.00%), q=5.27, 8.21, P<0.01] and there were not significant differences in the V20 level between the 3D-CRT+IMRT and IMRT groups (q=2.76, P＞0.05). There were not significant differences in the V45 levels among these 3 groups (F=0.69, P＞0.05). Conclusions The 3D-CRT+IMRT technique in PMRT effectively reduces the radiated dose on the ipsilateral lung. |
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