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Use of Three Dimensional Conformal Radiation Therapy for Node Positive Breast Cancer Does Not Result in Excess Lung and Heart Irradiation

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Document pages: 9 pages

Abstract: Purpose: This work evaluates the use of target and organs at risk (OAR) dose-volumegoals in 3D conformal radiotherapy (3DCRT) planning for node positive breastcancer (NPBC) patients undergoing regional nodal irradiation afterlumpectomy mastectomy. Methods: Dosimetric data for 262 NPBCpatients receiving regional nodal and whole breast chest wall (WB CW) irradiationfrom 2000-2009 were analyzed. In all cases, target & OAR volumes weredelineated on treatment CT scans for field generation and dose-volumehistograms (DVHs) were generated. Cases were analyzed to identify howfrequently they met treatment planning institutional dose-volume goals(“institutional guidelines” & standardized in 2005) and how this wouldaffect OAR doses. Results: The incidence of cases from 2000-2009meeting current institutional guidelines improved over the study period. Targetcoverage improved from 2005-2009, when guidelines were followed as a part of theplan approval. Those cases from 2000-2004 meeting acceptable target goals werefound to be significantly different from those cases from 2005-2009 (p Conclusions: Theuse of institutional guidelines in 3DCRT for WB CW and regional nodalirradiation for NPBC patients improved target coverage without a statisticallysignificant increase in heart and lung doses.

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