Intensity-modulated radiation therapy using TomoDirect for postoperative radiation of left-sided breast cancer including lymph node area: comparison with TomoHelical and threedimensional conformal radiation therapy

Intensity-modulated radiation therapy (IMRT) delivers an excellent dose distribution compared with conventional three-dimensional conformal radiation therapy (3D-CRT) for postoperative radiation including the lymph nodes in breast cancer patients. The TomoTherapy system, developed exclusively for IM...

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Bibliographic Details
Main Authors: Takano, Shoko, Omura, Motoko, Suzuki, Ryoko, Tayama, Yumiko, Matsui, Kengo, Hashimoto, Harumitsu, Hongo, Hideyuki, Nagata, Hironori, Tanaka, Kumiko, Hata, Masaharu, Inoue, Tomio
Format: Dissertation
Language:English
Subjects:
Breast cancer
Cancer patients
Cancer treatment
Care and treatment
Development and progression
Lymph nodes
Methods
Patient outcomes
Physiological aspects
Postoperative care
Radiation (Physics)
Radiotherapy
Women's health
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Summary:Intensity-modulated radiation therapy (IMRT) delivers an excellent dose distribution compared with conventional three-dimensional conformal radiation therapy (3D-CRT) for postoperative radiation including the lymph nodes in breast cancer patients. The TomoTherapy system, developed exclusively for IMRT, has two treatment modes: TomoDirect (TD) with a fixed gantry angle for beam delivery, and TomoHelical (TH) with rotational beam delivery. We compared the characteristics of TD with TH and 3D-CRT plans in the breast cancer patients. Ten consecutive women with left breast cancer received postoperative radiation therapy using TD including the chest wall/residual breast tissue and level II-III axial and supraclavicular lymph node area. Fifty percent of the planning target volume (PTV) was covered with at least 50 Gy in 25 fractions. TD, TH and 3D-CRT plans were created for each patient, with the same dosimetric constraints. TD and TH showed better dose distribution to the PTV than 3D-CRT. TD and 3D-CRT markedly suppressed low-dose spread to the lung compared with TH. Total lung V5 and V10 were significantly lower, while V20 was significantly higher in the TD and 3D-CRT plans. The mean total lung, heart and contralateral breast doses were significantly lower using TD compared with the other plans. Compared with 3D-CRT and TH, TD can provide better target dose distribution with optimal normal-organ sparing for postoperative radiation therapy including the chest wall/residual breast tissue and lymph node area in breast cancer patients. TD is thus a useful treatment modality in these patients. Keywords: breast cancer, radiation therapy; TomoTherapy; TomoDirect; TomoHelical
ISSN:0449-3060
1349-9157
DOI:10.1093/jrr/rrz052