Schmitt Martin, Chambrelant Isabelle, Hong Chheang Parigna, Pflumio Carole, Hild Carole, Petit Thierry, Noël Georges
Radiotherapy Department, Strasbourg Europe Cancer Institute, 17 Rue Albert Calmette, 67200 Strasbourg, France.
Radiotherapy Department, Khmer Soviet Friendship Hospital, Yuthapol Khemarak Phoumin Blvd, Phnom Penh 12306, Cambodia.
Cancers (Basel). 2022 Feb 4;14(3):807. doi: 10.3390/cancers14030807.
The dosimetric analysis of the incidental axillary dose delivered to axillary lymph node levels I-III by different techniques of whole breast irradiation and the analysis of prognostic factors of axillary recurrence of breast cancer.
We perform a retrospective analysis that includes 171 patients with localized breast carcinoma irradiated at Centre Paul Strauss. To be included in the study, patients had to have a histological confirmation of breast cancer diagnosis, surgical treatment without axillary lymph node dissection (ALND), whole breast irradiation without axillary irradiation by a specific field, and a treatment plan available.
Three patients had lymph node recurrence. There was no significant correlation between the maximal or mean dose delivered at the three axillary levels and the risk of axillary lymph node recurrence. There was no significant correlation between the irradiation technique and the risk of axillary lymph node recurrence. Two patients, both in the HT group, had lymphoedema. There was significantly more lymphoedema in the HT group than in the ST and IMRT groups ( < 0.048). The mean dose in level II was significantly higher in the group of patients with lymphoedema (3.45 Gy (1.08; 9.62) vs. 23.4 Gy (23.1; 23.6)) ( < 0.02).
The irradiation technique has an influence on the incidental dose delivered to the axillary area, but has no influence on the risk of axillary recurrence. The risk of lymphoedema could be related to the use of HT and the mean dose delivered at level II.
对不同全乳照射技术给予腋窝Ⅰ-Ⅲ级淋巴结的意外腋窝剂量进行剂量学分析，并分析乳腺癌腋窝复发的预后因素。
我们进行了一项回顾性分析，纳入了在保罗·施特劳斯中心接受照射的171例局限性乳腺癌患者。要纳入本研究，患者必须有乳腺癌诊断的组织学证实、未进行腋窝淋巴结清扫（ALND）的手术治疗、未通过特定野进行腋窝照射的全乳照射以及可用的治疗计划。
3例患者出现淋巴结复发。在三个腋窝水平给予的最大剂量或平均剂量与腋窝淋巴结复发风险之间无显著相关性。照射技术与腋窝淋巴结复发风险之间无显著相关性。HT组有2例患者出现淋巴水肿。HT组的淋巴水肿明显多于ST组和IMRT组（<0.048）。出现淋巴水肿的患者组Ⅱ水平的平均剂量显著更高（3.45 Gy（1.08；9.62）对23.4 Gy（23.1；23.6））（<0.02）。
照射技术对给予腋窝区域的意外剂量有影响，但对腋窝复发风险无影响。淋巴水肿风险可能与HT的使用以及Ⅱ水平给予的平均剂量有关。
