Back to Search
Start Over
A Retrospective Analysis of Dose Distribution and Toxicity in Patients with Left Breast Cancer Treated with Adjuvant Intensity-Modulated Radiotherapy: Comparison with Three-Dimensional Conformal Radiotherapy
- Source :
- Cancer Management and Research, Vol Volume 12, Pp 9173-9182 (2020)
- Publication Year :
- 2020
- Publisher :
- Dove Medical Press, 2020.
-
Abstract
- Chia-Hsin Chen,1 Ching-Chuan Hsieh,2 Chih-Shen Chang,1 Miao-Fen Chen1,3 1Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan; 2Department of General Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan; 3Chang Gung University College of Medicine, Taoyuan City, TaiwanCorrespondence: Miao-Fen ChenDepartment of Radiation Oncology, Chang Gung Memorial Hospital at Chiayi, Chiayi, TaiwanEmail miaofen@adm.cgmh.org.twBackground: A better understanding of the organs-at-risk (OAR) dose metrics and the related toxicity induced by radiotherapy (RT) for left breast cancer (BC) will improve the quality of life. This study addressed the issue for left-BC patients treated with intensity-modulated radiotherapy (IMRT) compared to three-dimensional conformal radiotherapy (3D-CRT).Patients and Methods: Between 2012 and 2018, 308 left-BC patients underwent adjuvant RT at our hospital. Before June 2015, 134 patients were treated with 3D-CRT. Thereafter, 174 patients underwent IMRT. The patient’s characteristics in the IMRT group did not significantly different compared to those in the 3D-CRT group.Results: Among the total study population, the incidence of ≥grade 2 radiation dermatitis (RID) was 17.3%. Higher volumes receiving 105% (≥ 5.7%) and 107% (≥ 1%) of prescribed dose and 3D-CRT technique were associated with a higher risk of RID. Regarding lung toxicity, the mean lung dose (≥ 10.2Gy) and V20 (≥ 20%) of ipsilateral lung were significantly associated with the incidence of RT-induced pulmonary changes. By dosimetry analysis, IMRT achieved better dose conformity and delivered lower mean doses to heart and ipsilateral lung compared to 3D-CRT. Furthermore, propensity sore and multivariate analysis showed that IMRT technique helped to reduce RT-induced dermatitis and lung toxicity.Conclusion: Our data suggest that the volume of OAR exposed to higher doses is a predictor of RT-induced toxicity. Adjuvant RT with IMRT technique offered better dose conformity and spared high-dose levels to OARs to reduce radiation-related morbidity for BC patients.Keywords: breast cancer, IMRT, 3D-CRT, OAR, toxicity
Details
- Language :
- English
- ISSN :
- 11791322
- Volume :
- ume 12
- Database :
- Directory of Open Access Journals
- Journal :
- Cancer Management and Research
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.5d9347a2dddf4bd482d0de3fc4fbd120
- Document Type :
- article