Dosimetric analysis of a simplified intensity modulation technique for prone breast radiotherapy Journal Article
| Authors: | Goodman, K. A.; Hong, L.; Wagman, R.; Hunt, M. A.; McCormick, B. |
| Article Title: | Dosimetric analysis of a simplified intensity modulation technique for prone breast radiotherapy |
| Abstract: | Purpose Prone-position breast radiotherapy (RT) has been described as an alternative technique to improve dose homogeneity for women with large, pendulous breasts. We report the feasibility and dosimetric analysis of a simplified intensity-modulated RT (IMRT) technique, previously reported for women in the supine treatment position, to plan prone-position RT to the intact breast. Methods and materials Twenty patients with clinical Stage TisN0-T1bN1 breast cancer undergoing breast-conserving therapy underwent whole breast RT using a prone position technique. The treatment plans were developed using both conventional tangents and a simplified intensity-modulated tangential beam technique based on optimization of the intensity distributions across the breast. The plans were compared with regard to the dose-volume parameters. Results Dose heterogeneity within the breast planning target volume was significantly greater for the conventional tangent plans. Of 20 patients, 16 (80%) received maximal doses of ≥110% using the conventional tangents vs. only 1 (5%) using the IMRT plan. The isodose level encompassing 5% of the planning target volume was reduced from an average of 110% with conventional tangents to 105% with IMRT. The maximal dose within the planning target volume was reduced from an average of 114% with conventional tangents to 107% with IMRT. The greatest improvement was seen in the patients with the most pendulous breasts. Conclusion An IMRT planning approach is feasible for prone-position breast RT and improves dose homogeneity, particularly in women with larger, pendulous breasts. Additional follow-up is necessary to determine whether the improvements in dose homogeneity impact acute toxicity and cosmetic outcome in this cohort of women who have historically suffered from poor cosmesis after breast-conserving therapy. © 2004 Elsevier Inc. |
| Keywords: | adult; cancer chemotherapy; clinical article; controlled study; aged; middle aged; intensity modulated radiation therapy; doxorubicin; fluorouracil; paclitaxel; cancer radiotherapy; methotrexate; cancer staging; breast cancer; radiotherapy dosage; radiotherapy; cyclophosphamide; breast neoplasms; oncology; risk assessment; health care; intensity-modulated radiotherapy; tumors; feasibility studies; radiation oncology; dosimetry; radiotherapy, conformal; patient treatment; body posture; posture; carcinoma, intraductal, noninfiltrating; carcinoma, ductal, breast; drug dosage; supine position; humans; human; female; priority journal; article; prone breast radiotherapy; breast-conserving therapy (bct) |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 60 |
| Issue: | 1 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2004-09-01 |
| Start Page: | 95 |
| End Page: | 102 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2004.02.016 |
| PROVIDER: | scopus |
| PUBMED: | 15337544 |
| DOI/URL: | |
| Notes: | Int. J. Radiat. Oncol. Biol. Phys. -- Cited By (since 1996):31 -- Export Date: 16 June 2014 -- CODEN: IOBPD -- Source: Scopus |
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