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Dosimetric comparison of level II lymph nodes between mono-isocentric and dual-isocentric approaches in 3D-CRT and IMRT techniques in breast radiotherapy of mastectomy patients

Published online by Cambridge University Press:  03 September 2019

Saba Nadi ,
Razzagh Abedi-Firouzjah ,
Amin Banaei Open the ORCID record for Amin Banaei [Opens in a new window] ,
Salar Bijari  and
Mahdi Elahi
Saba Nadi
Affiliation:
Department of Medical Physics, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
Razzagh Abedi-Firouzjah
Affiliation:
Department of Medical Physics, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
Amin Banaei*
Affiliation:
Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran Department of Radiology Technology, Faculty of Paramedical Sciences, Aja University of Medical Sciences, Tehran, Iran
Salar Bijari
Affiliation:
Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
Mahdi Elahi
Affiliation:
Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
*
Author for correspondence: Amin Banaei, Tarbiat Modares University Faculty of Medical Sciences, Jala-e-Al ahmad, Tehran, Tehran 14115111, Iran. E-mail: [email protected]
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Abstract

Aim:

To evaluate the dosimetric parameters of level II lymph nodes in chest wall three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) of mastectomy patients using dual-isocentric (DIT) and mono-isocentric techniques (MIT).

Materials and methods:

Computed tomography (CT) images of 20 mastectomy patients undergoing chest wall external radiotherapy were used as the input data for the abovementioned techniques. Selected dosimetric parameters were calculated for the axillary level I–III lymph nodes, chest wall, heart and lung. Paired t-test statistical analysis was used for comparing the results of MIT and DIT in both 3D-CRT and IMRT methods.

Results:

There were significant differences in Dmin (minimum dose), Dmax (maximum dose) and maximum–minimum dose between MIT and DIT techniques (13, −8·6, −52·2% differences for Dmin, Dmax and maximum–minimum, respectively) in IMRT. There were also significant differences for Dmean (mean dose), Dmax and maximum–minimum dose (7·8, −11·4, −44·6% differences in Dmean, Dmax and maximum–minimum, respectively) in 3D-CRT (p < 0·05). In addition, there were not any differences in the dosimetric parameters for heart, lung and level I and III lymph nodes.

Conclusion:

In both 3D-CRT and IMRT methods, level II lymph node dose distribution in MIT was closer to the prescribed dose compared with DIT due to the position of these nodes in the field junction area. To achieve a better dose homogeneity, it could be recommended to use MIT instead of DIT in 3D-CRT and IMRT for mastectomy patients.

Keywords

3D-CRTbreast cancerIMRTlymph nodesmono-isocentric technique
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 19 , Issue 3 , September 2020 , pp. 254 - 258
Copyright
© Cambridge University Press 2019

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