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KMID : 1164220170290010027
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Journal of Korean Society for Radiotherapeutic Technology
2017 Volume.29 No. 1 p.27 ~ p.35
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Assessment of peripheral organ doses according to radiotherapy plan for left-sided breast cancer with Lymph node using deep inspiration breath-hold (DIBH)
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Jung Da-Ee
Kang Hyo-Seok
Choi Byoung-Joon
Park Sang-Jun
Lee Geon-Ho
Lee Du-Sang
Ahn Min-Woo
Jeon Myeong-Su
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Abstract
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Purpose: On the left side, breast cancer patients have more side effects than those on the right side because of unnecessary doses in normal organs such as heart and lung. DIBH is performed to reduce this. To evaluate the dose of peripheral organs in the left breast cancer including supraclavicular lymph nodes and internal mammary lymph nodes according to the treatment planning method of Conventional Radiation Therapy, Intensity Modulated Radiation Therapy and Volumetric Modulated Arc Therapy.
Materials and Methods: We performed CT-simulation using free breathing and deep inspiration breath-hold technique for 8 patients including left supraclavicular lymph nodes and internal mammary lymph nodes. Based on the acquired CT images, the contour of the body is drawn and the convention is performed so that 95%
Results: By applying the deep inspiration breath-hold technique, the mean interval between the heart and chest wall increased 1.6 ±0.6 cm. The mean dose of lung was 19.2 ±1.0 Gy, which was the smallest value in Intensity Modulated Radiation Therapy. The V30 (%) of the heart was 2.0 ±1.9, which was the smallest value in Intensity Modulated Radiation Therapy. In the left anterior descending coronary artery, the dose was 25.4 ±5.4 Gy, which was the smallest in Intensity Modulated Radiation Therapy. The maximum dose value of the Right breast was 29.7 ±4.3 Gy at Intensity Modulated Radiation Therapy.
Conclusion: When comparing the values of surrounding normal organs, Intensity Modulated Radiation Therapy and Volumetric Modulated Arc Therapy were applicable values for treatment. Among them, Intensity Modulated Radiation Therapy is considered to be a suitable treatment planning method.
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KEYWORD
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DIBH, Conventional RT, IMRT, VMAT, Cardiac, LAD
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