| Gu Xiaodong,Qi Xin,Wang Qingan,Gao Xianshu,Zhao B,Li Xiaomei,Li Hongzhen,Xin Ling,Liu Yinhua.An analysis of the incidental irradiation to the axillary levels Ⅰ-Ⅲ lymph node during radiotherapy after breast conserving surgery[J].Chinese Journal of Radiological Medicine and Protection,2018,38(6):434-438 |
| An analysis of the incidental irradiation to the axillary levels Ⅰ-Ⅲ lymph node during radiotherapy after breast conserving surgery |
| Received:January 22, 2018 |
| DOI：10.3760/cma.j.issn.0254-5098.2018.06.007 |
| KeyWords:Breast neoplasms/radiotherapy Conventional tangential field Three-dimensional conformal radiotherapy Intensity-modulated radiotherapy Axillary lymph node |
| FundProject: |
| Author Name | Affiliation | E-mail | | Gu Xiaodong | Department of Breast Radiation Oncology, Center of Radiation Therapy, Shanxi Cancer Hospital, Taiyuan 030013, China | | | Qi Xin | Department of Radiation Oncology, Peking University First Hospital, Beijing 100034, China | | | Wang Qingan | Department of Radiation Oncology, Peking University First Hospital, Beijing 100034, China | | | Gao Xianshu | Department of Radiation Oncology, Peking University First Hospital, Beijing 100034, China | gao7777@139.com | | Zhao B | Department of Radiation Oncology, Peking University First Hospital, Beijing 100034, China | | | Li Xiaomei | Department of Radiation Oncology, Peking University First Hospital, Beijing 100034, China | | | Li Hongzhen | Department of Radiation Oncology, Peking University First Hospital, Beijing 100034, China | | | Xin Ling | Department of General Surgery, Peking University First Hospital, Beijing 100034, China | | | Liu Yinhua | Department of General Surgery, Peking University First Hospital, Beijing 100034, China | |
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| Abstract:: |
| Objective To evaluate the incidental irradiation to the axillary levels Ⅰ,Ⅱ and Ⅲ during the whole breast radiotherapy after breast conserving surgery (BCS) without axillary lymph node dissection (ALND) in breast cancer (BC) patients. Methods A retrospective analysis was performed on the consecutive 42 cases of T1-2N0M0 stage BC patients with sentinel lymphnode biopsy (SLNB) and BCS but without ALND. The axillary lymph nodes of Ⅰ, Ⅱ and Ⅲ were delineated according to RTOG atlas guideline. Three radiotherapy plans including conventional tangential field (CTF), three-dimensional conformal radiotherapy (3D-CRT) and forward-planned intensity-modulated radiotherapy (IMRT) for whole breast irradiation were devised for each case. The Prescription dose was 50 Gy per 25 fractions. Doses to axillary levels (Ⅰ-Ⅲ) were evaluated. Results The mean doses delivered to axillary by the three techniques (CTF, 3D-CRT and IMRT) were (40.1±6.8), (35.4±8.3), (32.9±7.0) Gy for level Ⅰ (F=10.269,P<0.05), (33.2±7.1), (30.6±6.7), (30.4±7.0) Gy for level Ⅱ (P>0.05) and (9.6±6.8), (6.4±4.5), (5.2±3.7) Gy for level Ⅲ (F=8.377,P<0.05), respectively. V50(volume receiving 50 Gy) for the three techniques were 21.3%, 27.6%, 9.6% for level Ⅰ (F=13.161,P<0.05), 12.9%, 15.9%, 8.3% for level Ⅱ(F=2.750,P<0.05)and 0.4%, 0.1% and 0% for level Ⅲ(P>0.05), respectively. Conclusions The doses coverage to axillary levels Ⅰ-Ⅲ were all limited in the three techniques. Therefore, it is necessary to assess the risk of axillary lymph node metastasis adequately to develop individualized radiotherapy plans. |
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