Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-23T08:25:31.626Z Has data issue: false hasContentIssue false
  • English
  • Français

Effect of change in neck position on thyroid dose and volume in supraclavicular irradiation for breast cancer using conformal technique

Published online by Cambridge University Press:  01 March 2021

Sajeev George Pulickal ,
Nikhil Sebastian Open the ORCID record for Nikhil Sebastian [Opens in a new window] ,
Reshma Bhaskaran Open the ORCID record for Reshma Bhaskaran [Opens in a new window]  and
P Aparna
Sajeev George Pulickal
Affiliation:
Department of Radiotherapy and Oncology, Government T. D. Medical College, Vandanam, Alappuzha, Kerala688005
Nikhil Sebastian*
Affiliation:
Department of Medical Oncology, Medical Trust Hospital, Kochi, Kerala682036
Reshma Bhaskaran
Affiliation:
Department of Radiotherapy and Oncology, Government T. D. Medical College, Vandanam, Alappuzha, Kerala688005
P Aparna
Affiliation:
Department of Radiotherapy and Oncology, Government T. D. Medical College, Vandanam, Alappuzha, Kerala688005
*
Author for correspondence: Nikhil Sebastian, Department of Medical Oncology, Medical Trust Hospital, Kochi, Kerala682036. Tel: 091 854 736 8559. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background and aim:

Radiation exposure to the thyroid gland during breast irradiation can lead to hypothyroidism and this can impact on the quality of life. The aim of this study was to analyse if there is any difference in the radiation dose received by the thyroid gland during supraclavicular irradiation for breast cancer, with two different neck positions—straight or when the head is turned to the contralateral side to the breast being treated, when using a conformal technique.

Materials and methods:

All patients who received chest wall/breast and supraclavicular irradiation for breast cancer in 2019 in our department were divided into two groups based on the neck position as SN (neck positioned straight) and TN (neck tilted to contralateral side). The volume of thyroid gland, the radiation dose and volume parameters for Dmax, Dmean, and V5 to V40 of the thyroid were tabulated.

Results:

There were 72 patients included in the study with a mean age of 59 years, with 39 in the SN group and 33 in the TN group. There was no significant difference in thyroid volume between the two groups. Dmean, V15, V20, V25, V30 and V35 were significantly lower in tilted neck patients as compared to straight neck patients.

Conclusion:

Neck positioned to the contralateral side of the breast primary may be recommended for conformal CT-based radiation planning.

Keywords

carcinoma breastDmeanneck positionsupraclavicular irradiationthyroid
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 2 , June 2022 , pp. 234 - 238
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Cancer Society. Global Cancer Facts & Figures, 4th edition. Atlanta: American Cancer Society; 2018.Google Scholar
Akın, M, Ergen, A, Unal, A, Bese, N. Irradiation doses on thyroid gland during the postoperative irradiation for breast cancer. J Can Res Ther 2014; 10 (4): 942.CrossRefGoogle ScholarPubMed
Falstie-Jensen, AM, Esen, BÖ, Kjærsgaard, A et al. Incidence of hypothyroidism after treatment for breast cancer—a Danish matched cohort study. Breast Cancer Res [Internet]. 2020 [cited 2020 Nov 23]; 22. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7556927/ CrossRefGoogle Scholar
Kumar, NB, Fink, A, Levis, S, Xu, P, Tamura, R, Krischer, J. Thyroid function in the etiology of fatigue in breast cancer. Oncotarget 2018; 9 (39): 25723–25737.CrossRefGoogle ScholarPubMed
Moeller, LC, Führer, D. Thyroid hormone, thyroid hormone receptors, and cancer: a clinical perspective. Endocr Relat Cancer 2013; 20 (2): R19–R29.CrossRefGoogle ScholarPubMed
White, JT, Arthur, D, Buchholz, T et al. Radiation Therapy Oncology Group. Breast cancer atlas for radiation therapy planning: consensus definitions. 2013. [Internet]. NRG Oncology foundation, Four Penn Center, 1600 JFK Blvd, Suite 1020, Philadelphia, PA 1910; 2013 [cited 2020 Oct 11]. Available from: https://www.nrgoncology.org/ciro-breast Google Scholar
Darvish, L, Ghorbani, M, Teshnizi, SH et al. Evaluation of thyroid gland as an organ at risk after breast cancer radiotherapy: a systematic review and meta-analysis. Clin Transl Oncol 2018; 20 (11): 1430–1438.CrossRefGoogle ScholarPubMed
Tunio, MA, Al Asiri, M, Bayoumi, Y, Stanciu, LG, Al Johani, N, Al Saeed, EF. Is thyroid gland an organ at risk in breast cancer patients treated with locoregional radiotherapy? Results of a pilot study. J Cancer Res Ther 2015; 11 (4): 684–689.CrossRefGoogle ScholarPubMed
Kanyilmaz, G, Aktan, M, Koc, M, Demir, H, Demir, LS. Radiation-Induced hypothyroidism in patients with breast cancer: a retrospective analysis of 243 cases. Med Dosim 2017; 42 (3): 190–196.CrossRefGoogle ScholarPubMed
Haciislamoglu, E, Canyilmaz, E, Gedik, S, Aynaci, O, Serdar, L, Yoney, A. Effect of dose constraint on the thyroid gland during locoregional intensity-modulated radiotherapy in breast cancer patients. J Appl Clin Med Phys 2019; 20 (7): 135–141.CrossRefGoogle ScholarPubMed
Albuquerque, KV, Beall, N, Shah, K, Niemierko, A, Bova, D. Incidence and Predictors of Thyroid Dysfunction following Three-Dimensional Conformal Radiation Therapy (3D-CRT) to Low Neck as Component of Adjuvant Radiation in Women with Breast Cancer: Prospective Long Term Follow-Up. Int J Radiat Oncol Biol Phys 2009; 75 (3): S499.CrossRefGoogle Scholar
Reinertsen, KV, Cvancarova, M, Wist, E et al. Thyroid function in women after multimodal treatment for breast cancer Stage II/III: comparison with controls from a population sample. Int J Radiat Oncol Biol Phys 2009; 75 (3): 764–770.CrossRefGoogle ScholarPubMed