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Three-dimensional volumetric analysis of irradiated lung with adjuvant breast irradiation.
- Source :
-
International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2009 Dec 01; Vol. 75 (5), pp. 1309-15. Date of Electronic Publication: 2009 May 07. - Publication Year :
- 2009
-
Abstract
- Purpose: To retrospectively evaluate the dose-volume histogram data of irradiated lung in adjuvant breast radiotherapy (ABR) using a three-dimensional computed tomography (3D-CT)-guided planning technique; and to investigate the relationship between lung dose-volume data and traditionally used two-dimensional (2D) parameters, as well as their correlation with the incidence of steroid-requiring radiation pneumonitis (SRRP).<br />Methods and Materials: Patients beginning ABR between January 2005 and February 2006 were retrospectively reviewed. Patients included were women aged >or=18 years with ductal carcinoma in situ or Stage I-III invasive carcinoma, who received radiotherapy using a 3D-CT technique to the breast or chest wall (two-field radiotherapy [2FRT]) with or without supraclavicular irradiation (three-field radiotherapy [3FRT]), to 50 Gy in 25 fractions. A 10-Gy tumor-bed boost was allowed. Lung dose-volume histogram parameters (V(10), V(20), V(30), V(40)), 2D parameters (central lung depth [CLD], maximum lung depth [MLD], and lung length [LL]), and incidence of SRRP were reported.<br />Results: A total of 89 patients met the inclusion criteria: 51 had 2FRT, and 38 had 3FRT. With 2FRT, mean ipsilateral V(10), V(20), V(30), V(40) and CLD, MLD, LL were 20%, 14%, 11%, and 8% and 2.0 cm, 2.1 cm, and 14.6 cm, respectively, with strong correlation between CLD and ipsilateral V(10-V40) (R(2) = 0.73-0.83, p < 0.0005). With 3FRT, mean ipsilateral V(10), V(20), V(30), and V(40) were 30%, 22%, 17%, and 11%, but its correlation with 2D parameters was poor. With a median follow-up of 14.5 months, 1 case of SRRP was identified.<br />Conclusions: With only 1 case of SRRP observed, our study is limited in its ability to provide definitive guidance, but it does provide a starting point for acceptable lung irradiation during ABR. Further prospective studies are warranted.
- Subjects :
- Adult
Aged
Breast Neoplasms pathology
Carcinoma in Situ pathology
Carcinoma, Ductal, Breast pathology
Female
Humans
Imaging, Three-Dimensional methods
Lung pathology
Middle Aged
Radiation Pneumonitis etiology
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted methods
Radiotherapy, Adjuvant
Retrospective Studies
Tomography, X-Ray Computed methods
Tumor Burden
Young Adult
Breast Neoplasms radiotherapy
Carcinoma in Situ radiotherapy
Carcinoma, Ductal, Breast radiotherapy
Lung radiation effects
Subjects
Details
- Language :
- English
- ISSN :
- 1879-355X
- Volume :
- 75
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- International journal of radiation oncology, biology, physics
- Publication Type :
- Academic Journal
- Accession number :
- 19427749
- Full Text :
- https://doi.org/10.1016/j.ijrobp.2008.12.077