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Open Access 01-12-2017 | Research

Elective breast radiotherapy including level I and II lymph nodes: A planning study with the humeral head as planning risk volume

Authors: Kathrin Surmann, Jorien van der Leer, Tammy Branje, Maurice van der Sangen, Maarten van Lieshout, Coen W. Hurkmans

Published in: Radiation Oncology | Issue 1/2017

Abstract

Background

The aim of this study was to assess the dose to the humeral head planning risk volume with the currently used high tangential fields (HTF) and compare different planning techniques for breast radiotherapy including axillary level I and II lymph nodes (PTVn) while sparing the humeral head.

Methods

Ten patients with left-sided breast cancer were enrolled in a planning study with 16 fractions of 2.66 Gy. Four planning techniques were compared: HTF, HTF with sparing of the humeral head, 6-field IMRT with sparing of the humeral head and VMAT with sparing of the humeral head. The humeral head + 10 mm was spared by restricting V40Gy < 1 cc.

Results

The dose to the humeral head was too high with HTF (V40Gy on average 20.7 cc). When sparing the humeral head in HTF, PTVn V90% decreased significantly from 97.9% to 89.4%. 6-field IMRT and VMAT had a PTVn V90% of 98.2% and 99.5% respectively. However, dose to the lungs, heart and especially the contralateral breast increased with VMAT.

Conclusions

The humeral head is rarely spared when using HTF. When sparing the humeral head, the 6-field IMRT technique leads to adequate PTV coverage while not increasing the dose to the OARs.

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Title: Elective breast radiotherapy including level I and II lymph nodes: A planning study with the humeral head as planning risk volume
Authors: Kathrin Surmann
Jorien van der Leer
Tammy Branje
Maurice van der Sangen
Maarten van Lieshout
Coen W. Hurkmans
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2017
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/s13014-016-0759-7

ACC 2024 Congress

Springer Medicine

Elective breast radiotherapy including level I and II lymph nodes: A planning study with the humeral head as planning risk volume

Abstract

Background

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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