T. Jansson et al., RADIOTHERAPY OF BREAST-CANCER AFTER BREAST-CONSERVING SURGERY - AN IMPROVED TECHNIQUE USING MIXED ELECTRON-PHOTON BEAMS WITH A MULTILEAF COLLIMATOR, Radiotherapy and oncology, 46(1), 1998, pp. 83-89
Citations number
19
Categorie Soggetti
Oncology,"Radiology,Nuclear Medicine & Medical Imaging
Background and purpose: Loco-regional radiotherapy after breast cancer
surgery significantly reduces the risk of recurrences. An increase of
cardiac deaths for irradiated breast cancer patients has been reporte
d in some studies, especially for women with tumours in the left breas
t. The aim of this study was to compare retrospectively the convention
ally used technique using two opposed tangential photon beams with a m
odified technique using a combination of photon and electron beams to
find an optimal technique with respect to dose homogeneity in the brea
st and surrounding regional lymph nodes and a minimal dose in the orga
ns at risk. Materials and methods: Thirty patients with stage II breas
t cancer who received different types of adjuvant systemic therapy wer
e included in the investigation. Comparative dose planning of two tech
niques was performed, i.e. an isocentric technique with two photon bea
ms with coplanar medial beam edges and a technique with one electron a
nd three photon beams with a common isocentre for all beams aided by a
multileaf collimator. Results: The mixed technique was selected for e
ight of 12 patients with left-sided breast cancers because of signific
antly lower doses to the heart. However, the decision-making was influ
enced by many factors such as dose coverage of the target volume combi
ned with minimizing of the doses to the organs at risk and the contral
ateral breast. Conclusion: The use of the mixed technique will optimiz
e the loco-regional radiotherapy after breast-conserving surgery for m
any left-sided breast cancers. (C) 1998 Elsevier Science Ireland Ltd.