Prabhakar R, Julka P K, Malik M, Ganesh T, Joshi R C, Sridhar P S, Rath G K, Pant G S, Thulkar S
Department of Radiation Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi -110 029, India.
Technol Cancer Res Treat. 2007 Apr;6(2):135-8. doi: 10.1177/153303460700600210.
Contralateral breast (CLB) cancer is a rare but serious concern in radiotherapy. In this study, the CLB dose was measured using MOSFET dosimeter in 49 patients who underwent breast conservation surgery treated by different radiotherapy tangential field techniques, which included enhanced dynamic wedge (EDW), physical wedge, and intensity modulated radiation therapy (IMRT). The mean percent of the prescribed dose received by the contralateral areola in treatment technique using physical wedge (Cobalt), physical wedge (Linac), EDW, and IMRT were 4.27% (SD: 0.65), 3.61% (SD: 0.60), 3.38% (SD: 0.58), and 1.65% (SD: 0.24), respectively. There was a 29% CLB dose reduction at 3 cm from the medial tangential field border with IMRT compared to other wedged tangential field techniques. The study shows that the CLB dose could be reduced with IMRT or reducing or avoiding the medial wedge in conventional tangential field planning for breast cancer.
对侧乳腺癌（CLB）是放射治疗中一个罕见但严重的问题。在本研究中，使用金属氧化物半导体场效应晶体管（MOSFET）剂量仪对49例行保乳手术并采用不同放疗切线野技术（包括增强动态楔形板（EDW）、物理楔形板和调强放射治疗（IMRT））的患者测量了CLB剂量。在使用物理楔形板（钴）、物理楔形板（直线加速器）、EDW和IMRT的治疗技术中，对侧乳晕接受的处方剂量平均百分比分别为4.27%（标准差：0.65）、3.61%（标准差：0.60）、3.38%（标准差：0.58）和1.65%（标准差：0.24）。与其他楔形切线野技术相比，IMRT在距内侧切线野边界3 cm处可使CLB剂量降低29%。该研究表明，在乳腺癌的传统切线野规划中，采用IMRT或减少或避免内侧楔形板可降低CLB剂量。
