(S024) Axillary Lymph Node Coverage With 3D Tangential Field Irradiation and Correlation With Heart and Lung Dose

Publication
Article
OncologyOncology Vol 30 No 4_Suppl_1
Volume 30
Issue 4_Suppl_1

Less than 50% of the level I LN volume was covered by 90% PD; less than 30% was covered by 95% PD. Mean (29 Gy) and median (30 Gy) doses to the level I LN were subtherapeutic. There was a moderate correlation between V20 ipsilateral lung and coverage of level I LNs.

Matthew J. Miller, MD, Nicole Bunda-Randall, MS, DABR, Sijin Wen, PhD, Geraldine M. Jacobson, MD; West Virginia University

PURPOSE: The American College of Surgeons Oncology Group (ACOSOG) Z0011 trial indicated no benefit to axillary lymph node dissection (ALND) following positive sentinel lymph node (SLN) biopsy in patients receiving breast radiation therapy (RT). We evaluated coverage of axillary level I–II LNs using Radiation Therapy Oncology Group (RTOG) contouring guidelines in three-dimensional (3D plans) and correlation with V20 ipsilateral lung and mean heart dose (MHD).

MATERIALS AND METHODS: We evaluated 50 CT-based tangential breast plans. Axillary level I–II LNs were contoured using RTOG guidelines. Volumes of level I–II LN regions covered by 90% and 95% of the prescription dose (PD) were calculated. Pearson correlation method and linear models were used in the correlative study.

RESULTS: Level 1 LN mean and median volume (MMV) covered by 90% of the PD was 46.8% and 47.2%, respectively (8.77%–88.95%); MMV covered by 95% of the PD was 30.8% and 29.62% (0–82.9%). Mean and median doses to the level 1 LN were 29.03 Gy and 30.13 Gy, respectively (5.47–46.74 Gy). MMV of level II LN covered by 90% of the PD was 2.49% and 0%, respectively (0–32.98%). Mean and median doses to the level 2 LN were 6.09 Gy and 2.12 Gy, respectively. Mean and median V20 ipsilateral lung were 6.73% and 6.7%, respectively (0.018%–22.9%). For left breast patients (20 of 50), mean and median MHD were 1.39 Gy and 1.24 Gy, respectively (0.48–5.10 Gy). We noted a moderate correlation between 95% prescription coverage of level 1 LNs and V20 ipsilateral lung (Pearson correlation = 0.51; P = .0001) and a smaller correlation between 95% prescription coverage of level 1 LNs and MHD (Pearson correlation = 0.49; P = .029).

CONCLUSION: Less than 50% of the level I LN volume was covered by 90% PD; less than 30% was covered by 95% PD. Mean (29 Gy) and median (30 Gy) doses to the level I LN were subtherapeutic. There was a moderate correlation between V20 ipsilateral lung and coverage of level I LNs.

Proceedings of the 98th Annual Meeting of the American Radium Society- americanradiumsociety.org

Articles in this issue

(S002) A 15-Year Review of Radiation Therapy for Keloids at Two Institutions
(S003) Single-Fraction Radiation Therapy for the Treatment of Multiple Myeloma Bony Metastases Provides Pain Control and Decreases Time to Chemotherapy
(S001) Prognostic Value of Pretreatment Serum Inflammatory Markers in Patients Receiving Radiation Therapy for Oropharyngeal Cancer
(S004) Trend in Second Malignancy Risk for Head and Neck Cancer With Increased Utilization of IMRT: Analysis of SEER Database
(S005) Comparison of Legal Needs of a Group of Patients With Cancer: Economic and Geographic Factors
(S006) Mission Improvement: Lessons From Initiating a Resident-Led Quality Improvement Project on Smoking Cessation at a County Hospital
(S007) Results of a Phase II Trial Using Cetuximab Plus Docetaxel With Low-Dose Fractionated Radiation for Recurrent Unresectable Locally Advanced Head and Neck Carcinoma
(S008) The Effect of Simulation and Treatment Delays for Patients With Oropharyngeal Cancer Receiving Definitive Radiation Therapy in the Era of Risk Stratification Using Smoking and Human Papilloma Virus Status
(S009) Intensity-Modulated Radiation Therapy With Stereotactic Body Radiation Therapy Boost for Unfavorable Prostate Cancer: A Report on Three-Year Toxicity
(S011) Comparative Study Between Ileal Conduit and Indiana Pouch After Cystectomy for Patients With Carcinoma of Urinary Bladder
(S010) Computed Tomography–Assessed Measures of Bone Mineral Density and Muscle Mass as Predictors of Survival in Men With Prostate Cancer
(S012) Quantitative Imaging to Evaluate the Malignant Potential of Pancreatic Cysts
(S013) Spine Stereotactic Radiosurgery With Concurrent Tyrosine Kinase Inhibitors for Metastatic Renal Cell Carcinoma
(S014) The Impact of Radiation Therapy on Survival in Surgically Resected, High-Risk Patients With Ampullary Adenocarcinoma: A Population-Based Analysis
(S016) The Impact of Stereotactic Body Radiation Therapy on Overall Survival in Patients With Locally Advanced Pancreatic Cancer
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