Abstract
The purpose of this study was to evaluate the skin-sparing effects of 3-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) in patients with early left-sided breast cancer. Twenty left breast cancer patients treated with whole breast radiotherapy following breast-conserving surgery were enrolled in this study, and the 3D-CRT and IMRT plans were generated for each patient. To evaluate the dose delivered to the skin, 2 mm thickness skin (2-mm skin) and 3 mm thickness skin (3-mm skin) were contoured and a dosimetric comparison between the 2 plans was performed. The target volume coverage was better in IMRT than in 3D-CRT. The mean dose was 50.8 Gy for 3D-CRT and 51.1 Gy for IMRT. V40Gy was 99.4% for 3D-CRT and 99.9% for IMRT. In the case of skin, the mean dose was higher in 3D-CRT than in IMRT (mean dose of 2-mm skin: 32.8 Gy and 24.2 Gy; mean dose of 3-mm skin: 37.2 Gy and 27.8 Gy, for 3D-CRT and IMRT, respectively). These results indicated that the skin-sparing effect is more prominent in IMRT compared to 3D-CRT without compromising the target volume coverage.
Highlights
Treatment for early breast cancer has changed in recent decades from radical mastectomy to breastconserving surgery (BCS) followed by postoperative adjuvant radiotherapy (RT), which is currently the treatment of choice, having shown excellent clinical results in terms of local control and overall survival [1]
The mean dose was increased in intensity-modulated radiotherapy (IMRT) compared to 3-dimensional conformal radiotherapy (3D-CRT)
In the case of the lung, the mean dose and low-to-moderate dose was increased in IMRT compared to 3D-CRT
Summary
Treatment for early breast cancer has changed in recent decades from radical mastectomy to breastconserving surgery (BCS) followed by postoperative adjuvant radiotherapy (RT), which is currently the treatment of choice, having shown excellent clinical results in terms of local control and overall survival [1]. By reducing mortality from breast cancer, patients became much more aware of several treatment-related complications affecting their quality of life. Commonly observed complication is radiationrelated dermatitis caused by whole breast radiotherapy (WBRT). There are on average 650 sweat glands, 20 blood vessels, 60,000 melanocytes, and more than 1,000 nerve endings in the space of 1 square inch of skin. For this reason, most breast cancer patients who undergo BCS followed by adjuvant RT develop various degree of radiation-related dermatitis with pain and other skin toxicities [2]
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