PMID- 31680445
OWN - NLM
STAT- MEDLINE
DCOM- 20200603
LR  - 20200603
IS  - 1526-9914 (Electronic)
IS  - 1526-9914 (Linking)
VI  - 20
IP  - 12
DP  - 2019 Dec
TI  - Dosimetric comparison of three-dimensional conformal radiotherapy and 
      intensity-modulated radiotherapy for left-sided chest wall and lymphatic 
      irradiation.
PG  - 36-44
LID - 10.1002/acm2.12757 [doi]
AB  - INTRODUCTION: The aim of this study was to compare five different techniques for 
      chest wall (CW) and lymphatic irradiation in patients with left-sided breast 
      carcinoma. METHODS: Three-dimensional conformal radiotherapy (3DCRT), 
      forward-planned intensity-modulated radiotherapy (FP-IMRT), inverse-planned IMRT 
      (IP-IMRT; 7- or 9-field), and hybrid IP-/FP-IMRT were compared in 10 patients. 
      Clinical target volume (CTV) included CW and internal mammary (IM), 
      supraclavicular (SC), and axillary nodes. Planning target volumes (PTVs), CTVs, 
      and organs at risks (OARs) doses were analyzed with dose-volume histograms 
      (DVHs). RESULTS: No differences could be observed among the techniques for doses 
      received by 95% of the volume (D95%) of lymphatics. However, the FP-IMRT resulted 
      in a significantly lower D95% dose to the CW-PTV compared to other techniques 
      (P = 0.002). The 9-field IP-IMRT achieved the lowest volumes receiving higher 
      doses (hotspots). Both IP-IMRT techniques provided similar mean doses (Dmean) for 
      the left lung which were smaller than the other techniques. There was no 
      difference between the techniques for maximum dose (Dmax) of right breast. 
      However, FP-IMRT resulted in lower Dmean and volume of right breast receiving at 
      least 5 Gy doses compared to other techniques. CONCLUSION: The dose homogeneity 
      in CW-CTV was better using IMRT techniques compared to 3DCRT. Especially 9-field 
      IP-IMRT provided a more homogeneous dose distribution in IM and axillary CTVs. 
      Moreover, the OARs volumes receiving low radiation doses were larger with IP-IMRT 
      technique, while volumes receiving high radiation doses were larger with FP-IMRT 
      technique. Hybrid IMRT plans were found to have the advantages of both FP- and 
      IP-IMRT techniques.
CI  - (c) 2019 The Authors. Journal of Applied Clinical Medical Physics published by 
      Wiley Periodicals, Inc. on behalf of American Association of Physicists in 
      Medicine.
FAU - Kivanc, Huseyin
AU  - Kivanc H
AD  - Department of Radiation Oncology, School of Medicine, Hacettepe University, 
      Ankara, Turkey.
FAU - Gultekin, Melis
AU  - Gultekin M
AD  - Department of Radiation Oncology, School of Medicine, Hacettepe University, 
      Ankara, Turkey.
FAU - Gurkaynak, Murat
AU  - Gurkaynak M
AD  - Department of Radiation Oncology, School of Medicine, Hacettepe University, 
      Ankara, Turkey.
FAU - Ozyigit, Gokhan
AU  - Ozyigit G
AD  - Department of Radiation Oncology, School of Medicine, Hacettepe University, 
      Ankara, Turkey.
FAU - Yildiz, Ferah
AU  - Yildiz F
AD  - Department of Radiation Oncology, School of Medicine, Hacettepe University, 
      Ankara, Turkey.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20191103
PL  - United States
TA  - J Appl Clin Med Phys
JT  - Journal of applied clinical medical physics
JID - 101089176
SB  - IM
MH  - Female
MH  - Humans
MH  - Lymphatic Irradiation/*methods
MH  - Organs at Risk/*radiation effects
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/*methods
MH  - Radiotherapy, Conformal/*methods
MH  - Radiotherapy, Intensity-Modulated/*methods
MH  - Thoracic Wall/*radiation effects
MH  - Unilateral Breast Neoplasms/*radiotherapy
PMC - PMC6909119
OTO - NOTNLM
OT  - breast cancer
OT  - chest wall irradiation
OT  - intensity-modulated radiotherapy
OT  - lymphatic irradiation
OT  - three-dimensional conformal radiotherapy
COIS- No conflict of interest.
EDAT- 2019/11/05 06:00
MHDA- 2020/06/04 06:00
PMCR- 2019/11/03
CRDT- 2019/11/05 06:00
PHST- 2018/01/16 00:00 [received]
PHST- 2018/09/05 00:00 [revised]
PHST- 2018/10/07 00:00 [accepted]
PHST- 2019/11/05 06:00 [pubmed]
PHST- 2020/06/04 06:00 [medline]
PHST- 2019/11/05 06:00 [entrez]
PHST- 2019/11/03 00:00 [pmc-release]
AID - ACM212757 [pii]
AID - 10.1002/acm2.12757 [doi]
PST - ppublish
SO  - J Appl Clin Med Phys. 2019 Dec;20(12):36-44. doi: 10.1002/acm2.12757. Epub 2019 
      Nov 3.