Regional radiotherapy to axilla and supraclavicular fossa for adjuvant breast treatment: a comparison of four techniques

International Journal of Radiation Oncology, Biology, Physics
Catherine R JephcottCarrie-Lynne Swift

Abstract

The three techniques commonly used to treat the axilla and supraclavicular nodes in adjuvant radiotherapy all have significant disadvantages, including underdosing the deeper nodes, excessively irradiating normal tissues, or producing undesirable hot spots. We assessed whether an anterior field with posterior boost field to the axilla with customized compensation of the anterior beam (APcomp-PAboost) would minimize these drawbacks. The axillary and supraclavicular nodal volumes, planning target volume (PTV), irradiated volume, and brachial plexus were contoured for 10 patients. The plans for each technique-single anterior field (AP); anterior to posterior parallel pair (AP-PA); anterior field with posterior boost (AP-PAboost); and APcomp-PAboost-were then generated for each patient using CadPlan and compared. The AP plan gave poor PTV coverage in 60% of cases. The AP-PA provided good PTV coverage and minimal hot spots, but resulted in consistent unnecessary RT to the medial posterior neck. The skin and tissue of the medial posterior neck and chest wall (i.e., the tissue overlying the posterior half of the ribs and posterior to the latissimus dorsi muscle, which forms the posterior wall of the axilla) was incidentally included i...Continue Reading

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Citations

Aug 6, 2013·Medical Dosimetry : Official Journal of the American Association of Medical Dosimetrists·Victor HernandezMarta Bonet
May 4, 2012·Cancer radiothérapie : journal de la Société française de radiothérapie oncologique·P AuberdiacN Magné
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Sep 25, 2007·International Journal of Radiation Oncology, Biology, Physics·Raweewan LiengsawangwongThomas A Buchholz
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Apr 29, 2006·Acta Oncologica·Silvia Johansson
May 10, 2008·Acta Oncologica·Mette S ThomsenUNKNOWN Danish Breast Cancer Cooperative Group

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