The modified tangential irradiation technique for breast cancer: how to cover the entire axillary region
| Autor: | Atsushi Amemiya, Nobuhiro Tsukamoto, Shoji Kutsuki, Takatsugu Kawase, Michinao Sato, Ryochi Ishibashi, K. Toya, Osamu Kawaguchi, Atsuya Takeda, Atsushi Kubo, Naoyuki Shigematsu, Makoto Kondo |
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| Rok vydání: | 2000 |
| Předmět: |
Adult
Cancer Research medicine.medical_treatment Axillary lines Breast Neoplasms Mastectomy Segmental Breast cancer Medicine Humans Radiology Nuclear Medicine and imaging Radiation treatment planning Lymph node Aged Neoplasm Staging Aged 80 and over Radiation Lymphatic Irradiation Radiotherapy business.industry Anatomy Middle Aged medicine.disease Surgical Instruments Combined Modality Therapy Radiation therapy Axilla Lymphatic system medicine.anatomical_structure Oncology Lymphatic Metastasis Female Lymph business Nuclear medicine |
| Zdroj: | International journal of radiation oncology, biology, physics. 46(4) |
| ISSN: | 0360-3016 |
| Popis: | Purpose: The two-portal tangential irradiation technique has usually been applied to breast cancer patients after breast-conserving surgery (1, 2) and is expected to irradiate the axillary lymph node region to some extent (3). We investigated the range of the axillary region covered by this technique and tried to devise an optimal irradiation technique (modified tangential irradiation) that would cover the axillary lymph node region properly. Methods and Materials: We checked the status of the surgical clips left at axillary lymph node sites by reviewing the simulator films and planning CT scans of 63 patients who underwent axillary dissection of level I, I–II, or I–III lymph nodes. Then we created the modified tangential irradiation technique and applied this technique to 16 patients and checked the irradiation volume by CT scans. Results: We found that all of the surgical clips on lateral-view simulator films were on the ventral side of the dorsal edge line of the humeral head. All but one clip were on the caudal side of the caudal edge line of the humeral head. Accordingly, it is possible to irradiate almost all axillary lymph node regions by setting the dorsal edge of the irradiation field on lateral-view simulator films at the dorsal edge of the humeral head and the cranial edge at the caudal edge of the humeral head. Conclusions: All breast tissue and the entire axillary lymph node region can be covered by the modified tangential irradiation technique without increasing the lung volume irradiated. |
| Databáze: | OpenAIRE |
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