서울의대 / 김규보, 전민수, 신경환*
Abstract
Background/aim: To present the variations in the target delineation and the planning results of intensity-modulated radiation therapy (IMRT) for breast cancers.
Patients and methods: We requested the target volumes and organs at risk delineation for two cases of left breast cancers, and evaluated the IMRT plans including the supraclavicular and internal mammary node irradiation.
Results: Twenty-one institutions participated in this study. Differences in the planning target volume among institutions reached up to three-times for breast-conserving surgery (BCS) case and five-times for mastectomy case. Mean heart doses ranged from 3.3 to 24.1 Gy for BCS case and from 5.0 to 26.5 Gy for mastectomy case. Ipsilateral lung volumes receiving more than 20 Gy ranged from 4.7 to 57.4% for BCS case and from 16.4 to 55.5% for mastectomy case.
Conclusion: There were large variations in the target delineation and planning results of IMRT for breast cancers among institutions. Considering the increased use of breast IMRT, more standardized protocols are needed.
Affiliations
Kyubo Kim 1 , Minsoo Chun 2 , Hyeongmin Jin 2 , Wonguen Jung 1 , Kyung Hwan Shin 3 , Seong Soo Shin 4 , Yeon Joo Kim 5 , Shin-Hyung Park 6 , Jin Hee Kim 7 , Yong Ho Kim 8 , Hyun Soo Shin 9 , Haeyoung Kim 10 , Su Ssan Kim 11 , Jong Hoon Lee 12 , Yong Bae Kim 13 , Sun Young Lee 14 , Jinhyun Choi 15 , DO Hoon Oh 16 , Ki Mun Kang 17 , Jeanny Kwon 18 , Mi Young Kim 19 , Taeryool Koo 20 , Hae Jin Park 21 , Sung Ja Ahn 22
1 Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
2 Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea.
3 Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea; radiat@snu.ac.kr.
4 Department of Radiation Oncology, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea.
5 Department of Radiation Oncology, Kangwon National University School of Medicine, Chuncheon, Republic of Korea.
6 Department of Radiation Oncology, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
7 Department of Radiation Oncology, Keimyung University School of Medicine, Daegu, Republic of Korea.
8 Department of Radiation Oncology, Catholic Kwandong University, Incheon, Republic of Korea.
9 Department of Radiation Oncology, CHA University School of Medicine, Seongnam, Republic of Korea.
10 Department of Radiation Oncology, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
11 Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
12 Department of Radiation Oncology, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea.
13 Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Republic of Korea.
14 Department of Radiation Oncology, Jeonbuk National University School of Medicine, Jeonju, Republic of Korea.
15 Department of Radiation Oncology, Jeju National University School of Medicine, Jeju, Republic of Korea.
16 Department of Radiology, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
17 Department of Radiation Oncology, Gyeongsang National University School of Medicine, Changwon, Republic of Korea.
18 Department of Radiation Oncology, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
19 Department of Radiation Oncology, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
20 Department of Radiation Oncology, Hallym University College of Medicine, Anyang, Republic of Korea.
21 Department of Radiation Oncology, Hanyang University College of Medicine, Seoul, Republic of Korea.
22 Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea.