A new method to deliver supraclavicular radiation in breast radiotherapy for lung sparing

Bo Yang, Zheng Dong, Mu Han Lin, C. M. Ma

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Due to the angulation of the breast board used for tangential breast irradiation, additional normal lung tissues are included in the supraclavicular field. This work investigates a method to reduce the lung volume and dose delivered during supraclavicular irradiation for breast cancer. Ten patients included for this retrospective study received chest wall and supraclavicular irradiation following radical surgery or breast-conserving surgery. Three-dimensional conformal radiation therapy plans were generated using the CMS XiO treatment planning system. The clinical target volume (CTV) of the supraclavicular irradiation is defined as the subcutaneous tissues from 0.5 cm under the anterior skin surface to a 3 cm depth. Only the ipsilateral lung is defined as the organ at risk. In the new method, the couch is rotated 90° and the supraclavicular field is tilted to maintain a normal incident angle to the breast board rather than the couch surface to spare more normal lung tissues. The absolute volume of the ipsilateral lung irradiated, and the volumes of lung tissues receiving 5 Gy and 20 Gy (V5 and V20) are analyzed. The new method can reduce the lung volume irradiated by the supraclavicular field significantly. For the ten patients investigated, only 5.3% of the ipsilateral lung is irradiated with the new method, while 14.9% of the ipsilateral lung is irradiated using the conventional method. Compared with the conventional method, the new method reduces V5 by 53.6% and V20 by 59.0%. Our new method does not alter the patient positioning for breast treatment but rotates the couch to deliver a tilted supraclavicular field to maintain adequate CTV coverage and spare more normal lung tissues. The results of this study demonstrated that our new method is effective, and that the reduction of normal lung tissue volume in the field is significant.

Original languageEnglish (US)
Pages (from-to)169-177
Number of pages9
JournalJournal of Applied Clinical Medical Physics
Volume12
Issue number3
DOIs
StatePublished - Jan 1 2011

Fingerprint

Radiotherapy
breast
lungs
radiation therapy
Breast
Radiation
Tissue
Lung
radiation
Irradiation
couches
Surgery
irradiation
surgery
Dosimetry
Skin
Organs at Risk
Patient Positioning
Planning
Segmental Mastectomy

Keywords

  • Breast cancer
  • Radiation pneumonia
  • Radiotherapy
  • Supraclavicular irradiation

ASJC Scopus subject areas

  • Radiation
  • Instrumentation
  • Radiology Nuclear Medicine and imaging

Cite this

A new method to deliver supraclavicular radiation in breast radiotherapy for lung sparing. / Yang, Bo; Dong, Zheng; Lin, Mu Han; Ma, C. M.

In: Journal of Applied Clinical Medical Physics, Vol. 12, No. 3, 01.01.2011, p. 169-177.

Research output: Contribution to journalArticle

@article{104663389a464c4996f7a41f69c591bf,
title = "A new method to deliver supraclavicular radiation in breast radiotherapy for lung sparing",
abstract = "Due to the angulation of the breast board used for tangential breast irradiation, additional normal lung tissues are included in the supraclavicular field. This work investigates a method to reduce the lung volume and dose delivered during supraclavicular irradiation for breast cancer. Ten patients included for this retrospective study received chest wall and supraclavicular irradiation following radical surgery or breast-conserving surgery. Three-dimensional conformal radiation therapy plans were generated using the CMS XiO treatment planning system. The clinical target volume (CTV) of the supraclavicular irradiation is defined as the subcutaneous tissues from 0.5 cm under the anterior skin surface to a 3 cm depth. Only the ipsilateral lung is defined as the organ at risk. In the new method, the couch is rotated 90° and the supraclavicular field is tilted to maintain a normal incident angle to the breast board rather than the couch surface to spare more normal lung tissues. The absolute volume of the ipsilateral lung irradiated, and the volumes of lung tissues receiving 5 Gy and 20 Gy (V5 and V20) are analyzed. The new method can reduce the lung volume irradiated by the supraclavicular field significantly. For the ten patients investigated, only 5.3{\%} of the ipsilateral lung is irradiated with the new method, while 14.9{\%} of the ipsilateral lung is irradiated using the conventional method. Compared with the conventional method, the new method reduces V5 by 53.6{\%} and V20 by 59.0{\%}. Our new method does not alter the patient positioning for breast treatment but rotates the couch to deliver a tilted supraclavicular field to maintain adequate CTV coverage and spare more normal lung tissues. The results of this study demonstrated that our new method is effective, and that the reduction of normal lung tissue volume in the field is significant.",
keywords = "Breast cancer, Radiation pneumonia, Radiotherapy, Supraclavicular irradiation",
author = "Bo Yang and Zheng Dong and Lin, {Mu Han} and Ma, {C. M.}",
year = "2011",
month = "1",
day = "1",
doi = "10.1120/jacmp.v12i3.3374",
language = "English (US)",
volume = "12",
pages = "169--177",
journal = "Journal of Applied Clinical Medical Physics",
issn = "1526-9914",
publisher = "American Institute of Physics Publising LLC",
number = "3",

}

TY - JOUR

T1 - A new method to deliver supraclavicular radiation in breast radiotherapy for lung sparing

AU - Yang, Bo

AU - Dong, Zheng

AU - Lin, Mu Han

AU - Ma, C. M.

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Due to the angulation of the breast board used for tangential breast irradiation, additional normal lung tissues are included in the supraclavicular field. This work investigates a method to reduce the lung volume and dose delivered during supraclavicular irradiation for breast cancer. Ten patients included for this retrospective study received chest wall and supraclavicular irradiation following radical surgery or breast-conserving surgery. Three-dimensional conformal radiation therapy plans were generated using the CMS XiO treatment planning system. The clinical target volume (CTV) of the supraclavicular irradiation is defined as the subcutaneous tissues from 0.5 cm under the anterior skin surface to a 3 cm depth. Only the ipsilateral lung is defined as the organ at risk. In the new method, the couch is rotated 90° and the supraclavicular field is tilted to maintain a normal incident angle to the breast board rather than the couch surface to spare more normal lung tissues. The absolute volume of the ipsilateral lung irradiated, and the volumes of lung tissues receiving 5 Gy and 20 Gy (V5 and V20) are analyzed. The new method can reduce the lung volume irradiated by the supraclavicular field significantly. For the ten patients investigated, only 5.3% of the ipsilateral lung is irradiated with the new method, while 14.9% of the ipsilateral lung is irradiated using the conventional method. Compared with the conventional method, the new method reduces V5 by 53.6% and V20 by 59.0%. Our new method does not alter the patient positioning for breast treatment but rotates the couch to deliver a tilted supraclavicular field to maintain adequate CTV coverage and spare more normal lung tissues. The results of this study demonstrated that our new method is effective, and that the reduction of normal lung tissue volume in the field is significant.

AB - Due to the angulation of the breast board used for tangential breast irradiation, additional normal lung tissues are included in the supraclavicular field. This work investigates a method to reduce the lung volume and dose delivered during supraclavicular irradiation for breast cancer. Ten patients included for this retrospective study received chest wall and supraclavicular irradiation following radical surgery or breast-conserving surgery. Three-dimensional conformal radiation therapy plans were generated using the CMS XiO treatment planning system. The clinical target volume (CTV) of the supraclavicular irradiation is defined as the subcutaneous tissues from 0.5 cm under the anterior skin surface to a 3 cm depth. Only the ipsilateral lung is defined as the organ at risk. In the new method, the couch is rotated 90° and the supraclavicular field is tilted to maintain a normal incident angle to the breast board rather than the couch surface to spare more normal lung tissues. The absolute volume of the ipsilateral lung irradiated, and the volumes of lung tissues receiving 5 Gy and 20 Gy (V5 and V20) are analyzed. The new method can reduce the lung volume irradiated by the supraclavicular field significantly. For the ten patients investigated, only 5.3% of the ipsilateral lung is irradiated with the new method, while 14.9% of the ipsilateral lung is irradiated using the conventional method. Compared with the conventional method, the new method reduces V5 by 53.6% and V20 by 59.0%. Our new method does not alter the patient positioning for breast treatment but rotates the couch to deliver a tilted supraclavicular field to maintain adequate CTV coverage and spare more normal lung tissues. The results of this study demonstrated that our new method is effective, and that the reduction of normal lung tissue volume in the field is significant.

KW - Breast cancer

KW - Radiation pneumonia

KW - Radiotherapy

KW - Supraclavicular irradiation

UR - http://www.scopus.com/inward/record.url?scp=80052183891&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052183891&partnerID=8YFLogxK

U2 - 10.1120/jacmp.v12i3.3374

DO - 10.1120/jacmp.v12i3.3374

M3 - Article

VL - 12

SP - 169

EP - 177

JO - Journal of Applied Clinical Medical Physics

JF - Journal of Applied Clinical Medical Physics

SN - 1526-9914

IS - 3

ER -