Abstract：Objective: To evaluate the dosimetric characteristics of axillary nodes with intensity modulated radiotherapy after breast conserving surgery. Methods: From November 2020 to November 2021, 16 consecutive left breast cancer patients were enrolled after breast conserving surgery. According to the ESTRO guidelines, the axillary level I and level II + interpectoral nodes were delineated. Four regimens are prepared: intensity-modulated radiotherapy based on tangential field for whole breast target (IMRT) or whole breast + axillary nodes target (IMRTn), volume modulated arc therapy for whole breast target (VMAT) or whole breast + axillary nodes target (VMATn). The prescription dose is 50 Gy per 25 fractions, and the relevant dosimetric parameters of each regimen are recorded. Results: The mean doses delivered to axillary nodes by IMRT and VMAT were (33.2±7.3) Gy and (32.6±7.4) Gy for level I (P = 0.477), (32.4±7.5) Gy and (30.2±7.8) Gy for level II + interpectoral nodes (P<0.001), respectively. The conformal index of IMRTn and IMRT were (0.698±0.05) and (0.753±0.03), (P = 0.001), (0.835±0.03) for VMATn and (0.857±0.04) for VMAT, (P = 0.018). The mean doses to ipsilateral lung by IMRT, IMRTn, VMATn were (10.3±1.2) Gy, (11.2±1.0) Gy and (10.5±0.8) Gy, respectively (P = 0.040). The V5 (volume receiving 5 Gy) to ipsilateral lung by IMRT, IMRTn, VMATn were (33.4±3.5)%, (38.5±3.7)% and (40.5±3.1)%, respectively (P<0.001). The mean doses to contralateral breast were (1.5±0.4) Gy, (1.7±0.7) Gy and (2.3±0.8) Gy, respectively (P = 0.006). Conclusion: The dose of axillary nodes was insufficient during whole breast radiotherapy. Whole breast + axillary area irradiation could deliver adequate prescription dose, and increase little dose to the normal tissues, but they were all lower than required dose constraints.
倪文婕, 王钦, 王秀楠, 侯栋梁, 孙保锦, 宋丽楠, 杨慧, 刘骁蕾, 张楠, 赵磊. 乳腺癌保乳术后调强放疗腋窝的剂量学研究[J]. 河北医学, 2022, 28(6): 930-933.
NI Wenjie, WANG Qin, WANG Xiunan, et al. Dosimetric Study of Intensity-Modulated Radiotherapy to the Axilla after Breast-Conserving Surgery for Breast Cancer. HeBei Med, 2022, 28(6): 930-933.
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2022, Vol. 28 
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