Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Radiol. Sep 28, 2011; 3(9): 233-240
Published online Sep 28, 2011. doi: 10.4329/wjr.v3.i9.233
Assessment of contralateral mammary gland dose in the treatment of breast cancer using accelerated hypofractionated radiotherapy
Maria Tolia, Kalliopi Platoni, Andreas Foteineas, Maria-Aggeliki Kalogeridi, Anna Zygogianni, Nikolaos Tsoukalas, Mariangela Caimi, Niki Margari, Maria Dilvoi, Panagiotis Pantelakos, John Kouvaris, Vassilis Kouloulias
Maria Tolia, Kalliopi Platoni, Andreas Foteineas, Maria-Aggeliki Kalogeridi, Anna Zygogianni, Maria Dilvoi, Panagiotis Pantelakos, John Kouvaris, Vassilis Kouloulias, 1st and 2nd Department of Radiology, Radiation Oncology Unit, Medical School, Athens 12462, Greece
Nikolaos Tsoukalas, Oncology Clinic, 401 Military Hospital, Athens 11525, Greece
Mariangela Caimi, Department of Radiation Oncology, San Raffaele Hospital, Milan 20132, Italy
Niki Margari, Department of Cytology, Medical School, Athens 12462, Greece
Author contributions: Tolia M, Platoni K, Fotineas A, Kalogeridi MA, Zygogianni A, Dilvoi M and Kouloulias V performed the measurements, collected the data and wrote the Results and Discussion sections; Tolia M, Tsoukalas N, Caimi M, Margari N and Pantelakos P wrote the Introduction and Methods and Materials sections; Kouvaris J made the final edit.
Correspondence to: Dr. Maria Tolia, 2nd Department of Radiology, Radiation Oncology Unit, Medical School, Athens 12462, Greece. mariatolia@yahoo.gr
Telephone: +30-21-5831860 Fax: +30-21-5326418
Received: January 15, 2011
Revised: July 18, 2011
Accepted: July 25, 2011
Published online: September 28, 2011
Abstract

AIM: To measure the dose distribution, related to the treatment planning calculations, in the contralateral mammary gland of breast cancer patients treated with accelerated hypofractionated 3-dimensional conformal radiotherapy.

METHODS: Thirty-four prospectively selected female patients with right breast cancer (pN0, negative surgical margins) were treated with breast-conserving surgery. A total dose of 42.5 Gy (2.66 Gy/fraction) was prescribed; it was requested that planning target volumes be covered by the 95% isodose line. The contralateral mammary gland was defined on CT simulation. The dose received was evaluated by dose volume histograms.

RESULTS: The measured contralateral breast doses were: (1) Dose maximum: 290-448 cGy [Equivalent (Eq) 337-522 cGy]; (2) Mean dose: 45-70 cGy (Eq 524-815 cGy); and (3) Median dose: 29-47 cGy (337-547 cGy) for total primary breast dose of 42.5 Gy in 16 equal fractions. The spearman rho correlation showed statistical significance between the contralateral breast volume and maximum dose (P = 0.0292), as well as mean dose (P = 0.0025) and median dose (P = 0.046) to the breast.

CONCLUSION: Minimizing the dose to the contralateral breast has to be one of the priorities of the radiation oncologist when using short schedules because of the radiosensitivity of this organ at risk. Further study is necessary to assess the long-term clinical impact of this schedule.

Keywords: Breast cancer, Hypofractionation, Contralateral breast, Dose calculation