Impact of inter-observer variability on first axillary level dosimetry in breast cancer radiotherapy: An AIRO multi-institutional study.

Autor:	Leonardi MC; Division of Radiation Oncology, Istituto Europeo di Oncologia, IRCCS, Milano, Italy., Pepa M; Division of Radiation Oncology, Istituto Europeo di Oncologia, IRCCS, Milano, Italy., Zaffaroni M; Division of Radiation Oncology, Istituto Europeo di Oncologia, IRCCS, Milano, Italy., Vincini MG, Luraschi R; Unit of Medical Physics, Istituto Europeo di Oncologia, IRCCS, Milano, Italy., Vigorito S; Unit of Medical Physics, Istituto Europeo di Oncologia, IRCCS, Milano, Italy., Morra A; Division of Radiation Oncology, Istituto Europeo di Oncologia, IRCCS, Milano, Italy., Dicuonzo S; Division of Radiation Oncology, Istituto Europeo di Oncologia, IRCCS, Milano, Italy., Mazzola GC; Division of Radiation Oncology, Istituto Europeo di Oncologia, IRCCS, Milano, Italy., Gerardi MA; Division of Radiation Oncology, Istituto Europeo di Oncologia, IRCCS, Milano, Italy., Zerella MA; Division of Radiation Oncology, Istituto Europeo di Oncologia, IRCCS, Milano, Italy., Cante D; Radiotherapy Department, ASL TO4 Ivrea Community Hospital, Ivrea, Italy., Petrucci E; Unit of Medical Physics, ASL TO4 Ivrea Community Hospital, Ivrea, Italy., Borzì G; Unit of Medical Physics, REM Radioterapia, Viagrande, Italy., Marrocco M; Unit of Medical Physics, Campus Bio-Medico University, Roma, Italy., Chieregato M; Unit of Medical Physics, Fondazione Poliambulanza, Brescia, Italy., Iadanza L; Unit of Medical Physics, Azienda Ospedaliera di Rilievo Nazionale San Pio, Benevento, Italy., Lobefalo F; Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Centre IRCCS, Milano, Italy., Valenti M; Unit of Medical Physics, Ospedali Riuniti Umberto I, G.M. Lancisi, G. Salesi, Ancona, Italy., Cavallo A; Unit of Medical Physics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy., Russo S; Unit of Medical Physics, AUSL Toscana Centro, Ospedale Santa Maria Annunziata, Firenze, Italy., Guernieri M; Medical Physics Unit, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy., Malatesta T; Unit of Medical Physics, Ospedale Fatebenefratelli Isola Tiberina - Gemelli Isola, Roma, Italy., Meaglia I; Department of Radiation Oncology, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy., Liotta M; Unit of Medical Physics, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy., Palumbo I; Radiation Oncology section, University of Perugia and Perugia General Hospital, Perugia, Italy., Marcantonini M; Medical Physics Unit, University of Perugia and Perugia General Hospital, Perugia, Italy., Mezzenga E; Medical Physics Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori 'Dino Amadori', Meldola, Italy., Falivene S; Department of Radiotherapy, ASL Napoli1 Centro - Ospedale del Mare, Napoli, Italy., Arrichiello C; Unit of Radiotherapy, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italy., Barbero MP; Unit of Medical Physics, Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy., Ivaldi GB; Department of Radiation Oncology, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy., Catalano G; Department of Radiotherapy, IRCCS MultiMedica, Sesto San Giovanni, Italy., Vidali C; Department of Radiation Oncology, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy., Giannitto C; Division of Radiology, Istituto Europeo di Oncologia IRCCS, Milano, Italy., Ciabattoni A; Department of Radiotherapy, San Filippo Neri Hospital, ASL Roma 1, Roma, Italy., Meattini I; Radiation Oncology Unit - Oncology Department, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy.; Department of Experimental and Clinical Biomedical Sciences 'M. Serio', University of Florence, Firenze, Italy., Aristei C; Radiation Oncology section, University of Perugia and Perugia General Hospital, Perugia, Italy., Orecchia R; Scientific Direction, Istituto Europeo di Oncologia, IRCCS, Milano, Italy., Cattani F; Unit of Medical Physics, Istituto Europeo di Oncologia, IRCCS, Milano, Italy., Jereczek-Fossa BA; Division of Radiation Oncology, Istituto Europeo di Oncologia, IRCCS, Milano, Italy.; Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy.
Jazyk:	angličtina
Zdroj:	Tumori [Tumori] 2023 Dec; Vol. 109 (6), pp. 570-575. Date of Electronic Publication: 2023 Sep 09.
DOI:	10.1177/03008916231196801
Abstrakt:	This study quantified the incidental dose to the first axillary level (L1) in locoregional treatment plan for breast cancer. Eighteen radiotherapy centres contoured L1-L4 on three different patients (P1,2,3), created the L2-L4 planning target volume (single centre planning target volume, SC-PTV) and elaborated a locoregional treatment plan. The L2-L4 gold standard clinical target volume (CTV) along with the gold standard L1 contour (GS-L1) were created by an expert consensus. The SC-PTV was then replaced by the GS-PTV and the incidental dose to GS-L1 was measured. Dosimetric data were analysed with Kruskal-Wallis test. Plans were intensity modulated radiotherapy (IMRT)-based. P3 with 90° arm setup had statistically significant higher L1 dose across the board than P1 and P2, with the mean dose (Dmean) reaching clinical significance. Dmean of P1 and P2 was consistent with the literature (77.4% and 74.7%, respectively). The incidental dose depended mostly on L1 proportion included in the breast fields, underlining the importance of the setup, even in case of IMRT. Competing Interests: Declaration of Conflicting InterestThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Division of Radiotherapy IEO received research funding from AIRC (Italian Association for Cancer Research) and Fondazione IEO-CCM (Istituto Europeo di Oncologia-Centro Cardiologico Monzino) (all outside the current project). BAJF received speakers fee from Roche, Bayer, Janssen, Carl Zeiss, Ipsen, Accuray, Astellas, Elekta, IBA Astra Zeneca (all outside the current project). MCL received a speaker fee from Accuray Inc (outside the current project). SD received speakers fee from Accuray Asia (outside the current project). MGV was supported by a research fellowship from AIRC entitled “Radioablation ± hormonotherapy for prostate cancer oligorecurrences (RADIOSA trial): potential of imaging and biology”, registered at ClinicalTrials.gov NCT03940235, approved by the Ethics Committee of IRCCS Istituto Europeo di Oncologia and Centro Cardiologico Monzino (IEO-997). IEO, the European Institute of Oncology IRCCS, was partially supported by the Italian Ministry of Health with Ricerca Corrente and 5x1000 funds and by institutional grants from Accuray Inc. The sponsors did not play any role in the study design, collection, analysis and interpretation of data, nor in the writing of the manuscript, nor in the decision to submit the manuscript for publication. The remaining authors declare no conflict of interest that are relevant to the content of this article.
Databáze:	MEDLINE
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