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Stranzl, H; Zurl, B; Langsenlehner, T; Kapp, KS.
Wide tangential fields including the internal mammary lymph nodes in patients with left-sided breast cancer. Influence of respiratory-controlled radiotherapy (4D-CT) on cardiac exposure.
Strahlenther Onkol. 2009; 185(3):155-160 Doi: 10.1007/s00066-009-1939-2
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Führende Autor*innen der Med Uni Graz
Stranzl-Lawatsch Heidi
Co-Autor*innen der Med Uni Graz
Kapp Karin S.
Langsenlehner Tanja
Zurl Brigitte

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To evaluate the impact of wide-tangent fields including the internal mammary chain during deep inspiration breath-hold (DIBH) radiotherapy in patients with left-sided breast cancer on cardiac exposure. Eleven patients with left-sided breast cancer were irradiated postoperatively and underwent CT scans during free breathing and DIBH. For scientific interest only, treatment plans were calculated consisting of wide tangents including the ipsilateral mammary lymph nodes using both, the free breathing and respiratory-controlled CT scan. The resulting dose-volume histograms were compared for irradiated volumes and doses to organs at risk. The mean patient age was 51 years (range: 37-65 years). Radiotherapy using wide tangents with DIBH as compared to free breathing led to a significantly lower cardiac exposure. Mean irradiated heart volumes (> or = 20 Gy) were 14 cm(3) (range: 0-51.3 cm(3)) versus 35 cm(3) (range: 2.1-78.7 cm(3); p = 0.01). For eight patients, DIBH reduced irradiated relative lung volume, while in three patients, the lung volume slightly increased. Radiation exposure of organs at risk can significantly be reduced for breast cancer patients using the DIBH technique. If radiotherapy of the internal mammary lymph nodes is considered necessary, DIBH may be the preferable technique.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Aged -
Body Burden -
Breast Neoplasms - diagnostic imaging
Breast Neoplasms - radiotherapy
Female -
Heart - radiation effects
Humans -
Lymph Nodes - diagnostic imaging
Lymph Nodes - radiation effects
Lymphatic Metastasis -
Middle Aged -
Motion -
Radiation Dosage -
Radiation Protection - methods
Radiography -
Relative Biological Effectiveness -
Respiratory Mechanics -
Respiratory-Gated Imaging Techniques - methods
Treatment Outcome -

Find related publications in this database (Keywords)
Left-sided breast carcinoma
Deep inspiration breath-hold technique
Internal mammary chain
Organs at risk
Wide tangents
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