Volume : VIII, Issue : XII, December - 2019

3DCRT vs IMRT : A changing paradigm in postmastectomy irradiation of chest wall and regional nodes : A comparative study of: Dosimetry,Toxicity and Outcome at the end of 3 years

Dr Pallavi Kalbande, Dr Virendra Vyas, Jay Phate

Abstract :

BACKGROUND–Breast cancer is the most common cancer among females.In India maximum no of cases presents in locally advanced stage,whereas lymph node positivity is seen in 80.2% patients.Radiotherapy is known to improve locoregional control and overall survival in post mastectomy patients. OBJECTIVE–To compare dose distribution to target volumes and OARs using 3DCRT and IMRT in post mastectomy patients followed by acute,late toxicity and outcome. METHODOLOGY– 25 unselected postmastectomy east cancer patients with indication for chestwall and supraclavicular nodal irradiation were planned with 3DCRT and IMRT technique both plans were compared.13 patients were treated with 3DCRT and 12 with IMRT plan toxicities,LRC,DM and OS were recorded for comparison. RESULTS–IMRT technique was significantly better in terms of max,min,mean dose,CI and HI of PTV(p<0.05).Irradiated volume of lung is significantly lower in IMRT.low dose volumes are much higher in IMRT(p<0.05).In left sided patients Dmax for LAD and and V20Gy,V25Gy of heart less in IMRT(<0.05) Radiation dermatitis at the end of radiotherapy was less in IMRT groups(p<0.05).Other toxicities were similar in both groups.At median f/u of 44 months OS was 69% in 3DCRT arm against 91%in IMRT(p<0.05).LR was 15% in 3DCRT arm and 0% in IMRT(p=0.08).DM was 8% in IMRT arm and 23% in 3DCRT arm. CONCLUSION–IMRT plan significantly improves CI,HI and reduces high dose volumes of lung,heart and LAD.Dosimetric superiority of IMRT turned into better LRC and OS at the end of 3 yrs.Radiation dermatitis was less in IMRT arm other toxicities were similar in both groups.

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Article: Download PDF    DOI : 10.36106/ijsr  

Cite This Article:

3DCRT VS IMRT : A CHANGING PARADIGM IN POSTMASTECTOMY IRRADIATION OF CHEST WALL AND REGIONAL NODES : A COMPARATIVE STUDY OF: DOSIMETRY,TOXICITY AND OUTCOME AT THE END OF 3 YEARS, Dr Pallavi Kalbande, Dr Virendra Vyas, Jay Phate INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH : Volume-8 | Issue-12 | December-2019

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