Dosimetric comparison of the field-in-field technique and tangential wedged beams for breast irradiation

Onal, Cem; Sonmez, Aydan; Arslan, G.; Oymak, Ezgi; Kotek, Ayse; Efe, Esma; Sonmez, Serhat; Dolek, Yemliha

doi:10.1007/s11604-011-0034-7

Cited by 37 publications

(35 citation statements)

References 26 publications

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“…Target coverage and dose uniformity parameters such as the planning target volume (PTV) doses, V 95 , V 100 , V 105 , and V 107 (PTV volume receiving 95%, 100%, 105%, and 107% of the prescribed dose, respectively) as well as doses to the organs at risk (OAR) such as the ipsilateral lung, heart, and contralateral breast have been compared. [1][2][3][4]24 A number of studies have reported significantly better dose distributions with FnF 2,4,7 and significant dose reduction to the OAR. 3,7,24 Gursel et al 3 attributed these improvements to the fact that the FnF technique reduces both the scatter and treatment time.…”

Section: Introductionmentioning

confidence: 99%

Dosimetric evaluation of whole-breast radiation therapy: Clinical experience

et al. 2015

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Section: Introductionmentioning

confidence: 99%

Dosimetric evaluation of whole-breast radiation therapy: Clinical experience

et al. 2015

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“…It is now estimated that, using standard tangential fields, more than 50% of level I and 20-30% of level II nodes receive 95% of the prescribed radiation dose [8,9,11,12]. The advantage of the field-in-field plan over the conventional wedge-inserted plan was also demonstrated in other reports [7,13]. Although the Z0011 protocol did not allow regional nodal irradiation, it is said that ACOSOG is currently working to extract the data on whether the radiation oncologist used high tangents to treat more of the level I and II nodes.…”

Section: Discussionmentioning

confidence: 88%

“…In contrast, the strength of this study is that it shows the clinical use of 3-D treatment planning to irradiate intentionally the large volume of level I and II nodes. While retrospective dosimetric studies have suggested the technical use of high tangent fields [7,11,12,13], this is the first study to demonstrate the impact of improved dose distribution on regional control in breast cancer management.…”

Section: Discussionmentioning

confidence: 99%

Axillary Irradiation with High Tangent Fields for Clinically Node-Negative Breast Cancer: Can 3-D Conformal Radiotherapy with a Field-in-Field Technique Better Control the Axilla?

et al. 2013

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Background: The target volume for postoperative breast irradiation is the remaining breast tissue, and the axillary region is not an intentional target volume. Patients and Methods: Between 2001 and 2009, eligible women with pT1-2cN0/pN0(sn) breast cancer underwent breast-conserving therapy without axillary dissection. Treatment outcomes between 2 radiotherapy planning groups, high tangent fields with 2-dimensional (2-D) simulation-based planning and 3-dimensional (3-D) computed tomography-based planning with a field-in-field technique, were compared. The correlating factors for axillary failure were also calculated. Results: In total, 678 patients were eligible. As of May 2009, the median follow-up times for the 2-D (n = 346) and 3-D (n = 332) groups were 94 and 52 months, respectively. Patient characteristics were balanced, except for a younger population in the 2-D group and more lymphovascular invasion in the 3-D group. On multivariate analysis, 2-D planning was the only risk factor for axillary failure. In the 2-D and 3-D groups, the 5-year cumulative incidences of axillary failure were 8 (3.1%) and 1 (0.3%) (log-rank p = 0.009), respectively. The respective 5-year overall survival rates were 97.4 and 98.4% (p = 0.4). Conclusion: High tangent irradiation with 3-D planning improved axillary control compared to that with 2-D planning, suggesting that optimizing axillary dose distribution may impact outcomes.

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“…In addition, radiotherapy planning for SSM requires less time because only a few subfields need to be generated. However, the method most commonly reported is the one in which multiple pairs of subfields are used [9–15, 18–23]. This method was classified as MSM.…”

Section: Discussionmentioning

confidence: 99%

Determination of the optimal method for the field-in-field technique in breast tangential radiotherapy

Tanaka

Hayashi

Hoshi

2014

Journal of Radiation Research

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Several studies have reported the usefulness of the field-in-field (FIF) technique in breast radiotherapy. However, the methods for the FIF technique used in these studies vary. These methods were classified into three categories. We simulated a radiotherapy plan with each method and analyzed the outcomes. In the first method, a pair of subfields was added to each main field: the single pair of subfields method (SSM). In the second method, three pairs of subfields were added to each main field: the multiple pairs of subfields method (MSM). In the third method, subfields were alternately added: the alternate subfields method (ASM). A total of 51 patients were enrolled in this study. The maximum dose to the planning target volume (PTV) (Dmax) and the volumes of the PTV receiving 100% of the prescription dose (V100%) were calculated. The thickness of the breast between the chest wall and skin surface was measured, and patients were divided into two groups according to the median. In the overall series, the average V100% with ASM (60.3%) was significantly higher than with SSM (52.6%) and MSM (48.7%). In the thin breast group as well, the average V100% with ASM (57.3%) and SSM (54.2%) was significantly higher than that with MSM (43.3%). In the thick breast group, the average V100% with ASM (63.4%) was significantly higher than that with SSM (51.0%) and MSM (54.4%). ASM resulted in better dose distribution, regardless of the breast size. Moreover, planning for ASM required a relatively short time. ASM was considered the most preferred method.

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Dosimetric comparison of the field-in-field technique and tangential wedged beams for breast irradiation

Abstract: The dose distribution within the target was more homogenous, and the doses for healthy tissue were less in the FIF plan compared to the tangential wedge plans.

Cited by 37 publications

References 26 publications

Dosimetric evaluation of whole-breast radiation therapy: Clinical experience

Dosimetric evaluation of whole-breast radiation therapy: Clinical experience

Axillary Irradiation with High Tangent Fields for Clinically Node-Negative Breast Cancer: Can 3-D Conformal Radiotherapy with a Field-in-Field Technique Better Control the Axilla?

Determination of the optimal method for the field-in-field technique in breast tangential radiotherapy

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