Research Papers:

Intensity modulated radiotherapy with fixed collimator jaws for locoregional left-sided breast cancer irradiation

Juanqi Wang, Zhaozhi Yang _, Weigang Hu, Zhi Chen, Xiaoli Yu and Xiaomao Guo

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Oncotarget. 2017; 8:33276-33284. https://doi.org/10.18632/oncotarget.16634

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Juanqi Wang1, Zhaozhi Yang1, Weigang Hu1, Zhi Chen1, Xiaoli Yu1, Xiaomao Guo1

1Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, 200032, Shanghai, China

Correspondence to:

Zhaozhi Yang, email: 13701773053@163.com

Weigang Hu, email: jackhuwg@gmail.com

Keywords: breast cancer, radiotherapy, regional lymph node, IMRT, fixed collimator jaws technique

Received: August 29, 2016     Accepted: March 08, 2017     Published: March 28, 2017


The purpose of this study is to evaluate the intensity modulated radiotherapy (IMRT) with the fixed collimator jaws technique (FJT) for the left breast and regional lymph node. The targeted breast tissue and the lymph nodes, and the normal tissues were contoured for 16 left-sided breast cancer patients previously treated with radiotherapy after lumpectomy. For each patient, treatment plans using different planning techniques, i.e., volumetric modulated arc therapy (VMAT), tangential IMRT (tangential-IMRT), and IMRT with FJT (FJT-IMRT) were developed for dosimetric comparisons. A dose of 50Gy was prescribed to the planning target volume. The dose-volume histograms were generated, and the paired t-test was used to analyze the dose differences. FJT-IMRT had similar mean heart volume receiving 30Gy (V30 Gy) with tangential-IMRT (1.5% and 1.6%, p = 0.41), but inferior to the VMAT (0.8%, p < 0.001). In the average heart mean dose comparison, FJT-IMRT had the lowest value, and it was 0.6Gy lower than that for the VMAT plans (p < 0.01). A significant dose increase in the contralateral breast and lung was observed in VMAT plans. Compared with tangential-IMRT and VMAT plans, FJT-IMRT reduced the mean dose of thyroid, humeral head and cervical esophageal by 47.6% (p < 0.01) and 45.7% (p < 0.01), 74.3% (p = < 0.01) and 73% (p = < 0.01), and 26.7% (p = < 0.01) and 29.2% (p = < 0.01). In conclusion, compared with tangential-IMRT and VMAT, FJT-IMRT plan has the lowest thyroid, humeral head and cervical esophageal mean dose and it can be a reasonable treatment option for a certain subgroup of patients, such as young left-breast cancer patients and/or patients with previous thyroid disease.

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