Cancer Res Treat.  2015 Jan;47(1):18-25. 10.4143/crt.2013.202.

A Phase I/II Trial to Evaluate the Technical Feasibility of Partial Breast Irradiation with Three-Dimensional Conformal Radiation Therapy in Korean Women with Stage I Breast Carcinoma: An Initial Report of the Korean Radiation Therapy Oncology Group (KROG) Study 0804

• Jeong JU
• Yoon JH
• Park MH
• Yoon MS
• Song JY
• Nam TK
• Chung WK
• Kim YH
• Suh CO
• Ahn SJ

• KMID: 2380386
• DOI: http://doi.org/10.4143/crt.2013.202

Abstract

PURPOSE
This prospective study was designed to verify the technical feasibility of partial breast irradiation in breast cancer patients with small breasts, which are commonly encountered in Korean women.
MATERIALS AND METHODS
A total of 40 Gy, administered in 10 fractions on consecutive days (one fraction per day), was prescribed to the isocenters of the fields using three-dimensional conformal radiotherapy (3-DCRT). For all patients, treatment planning and dose parameters strictly adhered to the constraints set forth in the Radiation Therapy Oncology Group (RTOG) 0319 protocol. This study was designed such that if fewer than five of the first 42 evaluable patients received unacceptable scores, the treatment would be considered reproducible.
RESULTS
Ten treatment plans (23.8%) were determined to have major variations. There was no major variation in planning target volume (PTV) coverage. The ipsilateral and contralateral breast dose limitations were not met in four (9.5%) and four cases (9.5%), respectively. Major variations in ipsilateral and contralateral lung dose limitations were observed in two cases (4.8%). Major variations in the heart and thyroid dose limitations were observed in one (2.4%) and one case (2.4%), respectively. In multivariate analysis, a ratio of PTV to ipsilateral breast volume (PTV/IB) > 0.16 was the only significant factor that statistically affected major variations.
CONCLUSION
We concluded that partial breast irradiation using 3-DCRT could not be reproduced in Korean breast cancer patients, particularly small-volumed breast surrogated as PTV/IB > 0.16. The dominant cause was the major variation in surrounding normal breast tissues.

Keyword

Breast neoplasms; Partial breast irradiation; Conformal radiotherapy

MeSH Terms

Breast Neoplasms*
Breast*
Female
Heart
Humans
Lung
Multivariate Analysis
Prospective Studies
Radiotherapy, Conformal
Thyroid Gland

Figure

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  Fig. 1. Dose distribution of partial breast irradiation using two coplanar and two non-coplanar photon beams.

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  Fig. 2. Dose volume histogram of partial breast irradiation using two coplanar and two non-coplanar photon beams. Lumpectomy cavity (purple), planning target volume (red), ipsilateral breast (yellow), contralateral breast (cyan), ipsilateral lung (blue), contralateral lung (green), and heart (orange) are depicted.

Reference

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