Internal mammarial lymph node radiotherapy in obese patients with breast cancer, at what expense?
International Journal of Radiation Research, cilt.18, sa.2, ss.191-200, 2020 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 18 Sayı: 2
- Basım Tarihi: 2020
- Doi Numarası: 10.18869/acadpub.ijrr.18.2.191
- Dergi Adı: International Journal of Radiation Research
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.191-200
- Anahtar Kelimeler: Breast cancer, Intensity-modulated radiation therapy, Internal mammary nodal area
- Ankara Yıldırım Beyazıt Üniversitesi Adresli: Evet
Özet
Background and Aim: The incidence of internal lymph node (IMN) involvement was 4-65% in breast cancer patents. Despite studies indicatng the positve effects of IMNRT on the oncological results, most of the clinicians avoided IMNRT because of the toxicity related to the increased dose of organs at risk (OAR). We aimed to compare the dosimetric results of RT plans with and without IMN containing planning target volumes (PTVs) using helical tomotherapy (HT) in obese patents. Materials and Methods: The PMRT data of 23 obese patents were evaluated retrospectvely/dosimetrically. Two PTVs with and without IMN were defined and two separate plans were made with HT. Dose received by IMN and OAR were compared. Results: The untargeted IMN V40were calculated between 0% to 99%. When the plans are evaluated in terms of critcal organs, the inclusion of the IMN into the target volume, the most significant adverse effect was observed in heart doses in the left chest wall (CW) irradiaton. The significant increases in cardiac V5(% 62.6 vs %48.6 p=0.007), V10(%38.2 vs %23.2 p=0.011), V20(%14.15 vs %9.06 p=0.045) and maximum heart dose (48.04 vs 43.2 p=0.043) were observed in the left-side CW irradiatons that involving the IMN. In CW irradiaton on the right side with IMN, only a significant increase in mean heart dose (5.44 vs 4.52 p=0.036) was observed. Lung V5doses were increased by inclusion with IMN in both sides. There was no difference in the contralateral breast doses in both plans for both sides. Conclusions: If the IMN is not targeted, some of the patents are getng appropriate doses in obese patents.