1Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing 100021,China; 2Department of Radiation Oncology,Peking University First Hospital,Beijing 100034,China
Objective To investigate the dose characteristics and outcomes of a single isocenter bilateral tangential fields (IBTF) combined with intensity-modulated radiotherapy (IMRT) in bilateral breast radiotherapy (BBR). Methods Fourteen female patients with synchronous bilateral breast cancer (SBBC) after breast-conserving surgery (BCS) were enrolled in this study. All patients received BBR using IBTF combined with IMRT at a conventional (50Gy/25f) or hypofractionated (43.5Gy/15f) dose. For patients with invasive cancer,the additional tumor bed boost was given with sequential electron radiation or simultaneously photon IMRT. The coverage, uniformity and short-term clinical efficacy were evaluated. Results The number of the irradiation field was 8-11,including 4-7 intensity-modulated fields. The bilateral breast PTV dose coverage reached 95% in all plans. For the tumor bed, the mean dose coverage was (95.54±1.33)%(left) and (94.19±1.03)%(right) using photon, and (90.25±8.79)%(left) and (85.28±8.35)%(right) using electron. The average V20 of bilateral lungs was (16.69±3.90)%. The cardiac Dmean was 5.48 Gy. Three patients presented with grade Ⅱ acute skin toxicities. No ≥ grade Ⅱ pneumonitis was observed. No recurrence occurred with the median follow-up time of 30.1 months. Eleven patients showed excellent cosmetic results. Conclusion BBR using IBTF combined with IMRT is efficacious and safe for patients with SBBC after BCS.
Ma Mingwei,Wang Shulian,Miao Junjie et al. Isocenter bilateral tangential fields combined with intensity-modulated radiotherapy for synchronous bilateral whole breast irradiation[J]. Chinese Journal of Radiation Oncology, 2019, 28(9): 677-681.
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2019, Vol. 28 
