AI Chat Paper
Note: Please note that the following content is generated by AMiner AI. SciOpen does not take any responsibility related to this content.
{{lang === 'zh_CN' ? '文章概述' : 'Summary'}}
{{lang === 'en_US' ? '中' : 'Eng'}}
Chat more with AI
Powered by AMiner. Clicking this button will take you away from SciOpen.
Home Precision Radiation Oncology Article
Article Link
Cite
EndNote(RIS) BibTeX
Collect
Show Outline
Outline
Show full outline
Hide outline
Outline
Show full outline
Hide outline
Original Article | Open Access

Assessment of dose-volume histogram statistics using three-dimensional conformal techniques in breast cancer adjuvant radiotherapy treatment

Aula Fadhil Alwan1( ), Manwar Abdulelah Al-Naqqash2, Hasan Saad Abbood Al-Nuami3, Nawres Ali Mousa4, Sura Yousif Ezzulddin4, Ahmed Salih Al-shewered5 ( ), Dalya Al-Nuami1
Radiation Oncology Department, Baghdad Center for Radiotherapy and Nuclear Medicine, Medical City Complex, Ministry of Health and Environment, Baghdad, Iraq
Department of Surgery, College of Medicine, Baghdad University, Baghdad, Iraq
Oncology Department, Næstved Hospital, Denmark
Medical Physics Department, Baghdad Center for Radiotherapy and Nuclear Medicine, Medical City Complex, Ministry of Health and Environment, Baghdad, Iraq
Department of Radiotherapy, Misan Radiation Oncology Center, Misan Health Directorate, Ministry of Health and Environment, Misan, Iraq
Show Author Information

Abstract

Objective

Breast cancer (BC) is first of the top 10 malignancies in Iraq. Dose-volume histograms (DVHs) are most commonly used as a plan evaluation tool. This study aimed to assess DVH statistics using three-dimensional conformal radiotherapies in BC in an adjuvant setting.

Methods

A retrospective study of 70 histologically confirmed women diagnosed with BC was reviewed. The study was conducted between November 2020 and May 2021, planning for treatment with adjuvant three-dimensional conformal radiotherapies. The treatment plan used for each woman was based on an analysis of the volumetric dose, including DVH analysis.

Results

The planning target volume and clinical target volume coverage for tumors at V85% was better than V90% and V95%, with highly significant differences (p < 0.0001). The planning target volume and clinical target volume coverage for lymph nodes at V85% was higher than V90% and V95%, with no significant differences.

Conclusions

This is the only study that has been carried out in Iraq that we are aware of that addresses the evaluation of DVH statistics in BC. V85% produced the best chest wall coverage, and V95% made the worst. With little significance, higher lymph nodes coverage was attained at V85%, whereas the lowest coverage was at V95%.

Keywords

breast cancerdose volume histogramorgans at riskthree-dimensional conformal radiotherapy

References

1

Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021; 71(3): 209-249.
Crossref Google Scholar
2
Iraqi Cancer Registry. Ministry Of Health, Iraqi Cancer Board, Baghdad. https://moh.gov.iq/upload/upfile/ar/273.pdf.2011
3
WHO. World Cancer Report. p. Chapter 5.2. ISBN 9283204298.[internet] Available at: https://publications.iarc.fr/Non-SeriesPublications/World-Cancer-Reports/World-Cancer-Report-2014
4

Early Breast Cancer Trialists' Collaborative Group (EBCTCG), Darby S, McGale P, et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011; 378(9804): 1707-1716.
Crossref Google Scholar
5

Overgaard M, Nielsen HM, Overgaard J. Is the benefit of postmastectomy irradiation limited to patients with four or more positive nodes, as recommended in international consensus reports? A subgroup analysis of the DBCGY 82 b & c randomized trials. Radiother Oncol. 2007; 82(3): 247-253.
Crossref Google Scholar
6

EBCTCGY (Early Breast Cancer Trialists' Collaborative Group), McGyale P, Taylor C, et al. Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials. Lancet. 2014; 383(9935): 2127-2135.
Crossref Google Scholar
7
Goyal S, Buchholz TA, Haffty BG. Breast cancer: early stage. In: EC Halperin et al. eds. Perez and Brady's Principles and Practice of Radiation Oncology. 6th ed. Lippincott Williams & Wilkins, a Wolters Kluwer business; 2015: 1044-1139.
8

van Herk M, Remeijer P, Rasch C, Lebesque JV. The probability of correct target dosage: dose-population histograms for deriving treatment margins in radiotherapy. Int J Radiat Oncol Biol Phys. 2000; 47(4): 1121-1135.
Crossref Google Scholar
9

Niemierko A, Goitein M. Modeling of normal tissue response to radiation: the critical volume model. Int J Radiat Oncol Biol Phys. 1993; 25(1): 135-145.
Crossref Google Scholar
10

Drzymala RE, Mohan R, Brewster L, et al. Dose-volume histograms. Int J Radiat Oncol Biol Phys. 1991; 21(1): 71-78.
Crossref Google Scholar
11
Purdy JA. In: EC Halperin, CA Perez, LW Brady, et al. eds. Principles and practice of radiation oncology: Conformal Radiation Therapy Physics, Treatment Planning, and Clinical Aspects: Dose–Volume Histograms. 6th ed. Lippincott Williams & Wilkins. 2015: 214-215.
12
Hasson, Brian F. Dose Volume Histogram (DVH). Encyclopedia of Radiation Oncology. p. 166. ISBN 978-3-540-85513-2. (https://doi.org/10.1007/978-3-540-85516-3_659) 2013.
13

Al-Naqqash MA, Al-Bdaer EK, Saleh WA, et al. Progression free survival in Iraqi breast cancer patients treated with adjuvant 3D conformal radiotherapy: a cross-sectional study. F1000Research. 2019; 8: 71.
Crossref Google Scholar
14

Al-Naqqash MA, Radhi SM, Tara Farooq Kareem TF, et al. Young age Iraqi Women with Breast Cancer: an overview of the correlation among their clinical and pathological profile. Med Sci. 2019; 23(95): 6-11.
Google Scholar
15

Al-Alwan NAS, Tawfeeq FN, Mallah NAG. Demographic and clinical profiles of female patients diagnosed with breast cancer in Iraq. J Contemp Med Sci. 2019; 5(1): 14-19.
Crossref Google Scholar
16

Al-Alwan, Kerr D, Dhafir Al-Okati D, et al. Comparative study on the clinicopathological profiles of breast cancer among Iraqi and British patients. Open Public Health J. 2018; 11: 177-191
Crossref Google Scholar
17

Al-Rawaq KJ, Al-Naqqash MA, Jassim MK. Molecular classification of Iraqi breast cancer patients and its correlation with patients' profile. J Fac Med Bagdad [Internet]. 2016; 58(3): 197-201.
Crossref Google Scholar
18
Oussama MNK, Modjtabai A. Guidelines for the early detection and screening of breast cancer: EMRO Technical Publications Series 30 WHO. 2006: 11-20.
19

Goldhirsch A, Winer EP, Coates AS, et al. Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013. Ann Oncol. 2013; 24(9): 2206-2223.
Crossref Google Scholar
20
Al-Khafaji AH. Immunohistochemical Expression of Estrogen, Progesterone Receptors, P53 and Ki67 in Iraqi and Syrian Breast Cancer Patients: A Clinicopathological Study. Thesis. Baghdad-Iraq. Baghdad-Iraq. University of Baghdad College of Medicine. 2010.
21
Al-Naqqash MA. The Role of c-myc Oncogene as a Prognostic Marker in Breast Cancer Patients Evaluated by Immunno-Histochemistry and In Situ Hypridization (Prospective Study). Thesis. Baghdad-Iraq. University of Baghdad College of Medicine. 2009.
22
SEER. Surveillance, Epidemiology, and End Results. Stat Fact Sheets: Breast Cancer. Archived from the original on 3 July 2014. Retrieved 18 June 2014. https://seer.cancer.gov.2014
23

Alwan NAS, Tawfeeq FT, Sattar SA, et al. Assessing the period between diagnosis of breast cancer and surgical treatment among mastectomized female patients in Iraq. Int J Med Res Health Sci. 2019; 8(1): 43-50.
Google Scholar
24

Alwan NAS, Tawfeeq FT, Muallah MH, et al. The stage of breast cancer at the time of diagnosis: correlation with the clinicopathological findings among Iraqi patients. J Neoplasm. 2017; 2(3): 11, 1–9.
Crossref Google Scholar
25

Whelan TJ, Olivotto I, Ackerman I, et al. NCIC-CTG MA. 20: an intergroup trial of regional nodal irradiation in early breast cancer. J Clin Oncol. 2011; 29(18): LBA1003.
Crossref Google Scholar
26

START Trialists' Group, Bentzen SM, Agrawal RK, et al. The UK Standardisation of Breast Radiotherapy (START) Trial B of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet. 2008; 371(9618): 1098-1107.
Crossref Google Scholar
27

START Trialists' Group, Bentzen SM, Agrawal RK, et al. The UK Standardisation of Breast Radiotherapy (START) Trial A of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet Oncol. 2008; 9(4): 331-341.
Crossref Google Scholar
28

Haviland JS, Owen JR, Dewar JA, et al. The UK Standardisation of Breast Radiotherapy (START) trials of radiotherapy hypofractionation for treatment of early breast cancer: 10-year follow-up results of two randomised controlled trials. Lancet Oncol. 2013; 14(11): 1086-1094.
Crossref Google Scholar
29

FAST Trialists group, Agrawal RK, Alhasso A, et al. First results of the randomised UK FAST Trial of radiotherapy hypofractionation for treatment of early breast cancer (CRUKE/04/015). Radiother Oncol. 2011; 100(1): 93-100.
Crossref Google Scholar
30

Dancey JE, Dodd LE, Ford R, et al. Recommendations for the assessment of progression in randomised cancer treatment trials. Eur J Cancer. 2009; 45(2): 281-289.
Crossref Google Scholar
31

Ohashi T, Takeda A, Shigematsu N, et al. Dose distribution analysis of axillary lymph nodes for three-dimensional conformal radiotherapy with a field-in-field technique for breast cancer. Int J Radiat Oncol Biol Phys. 2009; 73(1): 80-87.
Crossref Google Scholar
32

Takeda A, Shigematsu N, Ikeda T, et al. Evaluation of novel modified tangential irradiation technique for breast cancer patients using dose-volume histograms. Int J Radiat Oncol Biol Phys. 2004; 58(4): 1280-1288.
Crossref Google Scholar
33

Reznik J, Cicchetti MG, Degaspe B, Fitzgerald TJ. Analysis of axillary coverage during tangential radiation therapy to the breast. Int J Radiat Oncol Biol Phys. 2005; 61(1): 163-168.
Crossref Google Scholar
34

Bazeed Z, Attalla E, Awad I, Abdel Hamid M, Sarhan A. The effect of the number of fields on radiotherapy plans of breast cancer patients in three-dimensionally conformal radiotherapy plans: dosimetric studies. Middle East J Cancer. 2021; 12(4): 516-526
Google Scholar
35

Mansour Z, Ehab MA, Sarhan A, Awad IA, Abdel Hamid MI. Study the Influence of the number of beams on radiotherapy plans for the treatment of breast cancer using biological model. J Adv Phys. 2019; 16(1): 377-390.
Crossref Google Scholar
36

Alfonso JC, Herrero MA, Núñez L. A dose-volume histogram based decision-support system for dosimetric comparison of radiotherapy treatment plans. Radiat Oncol. 2015; 10: 263.
Crossref Google Scholar
37
Benson R, Mallick S, Rath GK. Case carcinoma breast. In: S Mallick, GK Rath, R Benson, eds. Practical Radiation Oncology. 1st ed. Springer Nature Singapore Pte Ltd. 2020: 201-209.
Crossref
38

Thompson RF. RadOnc: an R package for analysis of dose-volume histogram and three-dimensional structural data. J Radiat Oncol Info. 2017; 6(1): 98-110.
Crossref Google Scholar
39

Hortobagyi GN. Trastuzumab in the treatment of breast cancer. N Engl J Med. 2005; 353: 1734-1736.
Crossref Google Scholar
40

Al-Naqqash M, Jasim Al-Serarati W, Farooq Kareem T. Trastuzumab beyond progression in HER2-positive metastatic breast cancer. Breast J. 2021; 27(3): 297-299.
Crossref Google Scholar
41

Marks LB, Fan M, Clough R, et al. Radiation-induced pulmonary injury: symptomatic versus subclinical endpoints. Int J Radiat Biol. 2000; 76: 469-475.
Crossref Google Scholar
42

Hall EJ, Wuu CS. Radiation-induced second cancers: the impact of 3D-CRT and IMRT. Int J Radiat Oncol Biol Phys. 2003; 56(1): 83-88.
Crossref Google Scholar
43

Gao X, Fisher SG, Emami B. Risk of second primary cancer in the contralateral breast in women treated for early-stage breast cancer: a population-based study. Int J Radiat Oncol Biol Phys. 2003; 56(4): 1038-1045.
Crossref Google Scholar
44

Kirova YM, Gambotti L, De Rycke Y, et al. Risk of second malignancies after adjuvant radiotherapy for breast cancer: a large-scale, single-institution review. Int J Radiat Oncol Biol Phys. 2007; 68(2): 359-363.
Crossref Google Scholar
45

Mansouri S, Naim A, Glaria L, Marsiglia H. Dosimetric evaluation of 3-D conformal and intensity-modulated radiotherapy for breast cancer after conservative surgery. Asian Pac J Cancer Prev. 2014; 15(11): 4727-4732.
Crossref Google Scholar
46

Chitapanarux I, Nobnop W, Tippanya D, et al. Clinical outcomes and dosimetric study of hypofractionated Helical TomoTherapy in breast cancer patients. PLoS One. 2019; 14(1): e0211578.
Crossref Google Scholar
Precision Radiation Oncology
Volume 6 Issue 3,
September 2022
Pages 225-233
DOI: 10.1002/pro6.1172
Cite this article:
Alwan AF, Al-Naqqash MA, Al-Nuami HSA, et al. Assessment of dose-volume histogram statistics using three-dimensional conformal techniques in breast cancer adjuvant radiotherapy treatment. Precision Radiation Oncology, 2022, 6(3): 225-233. https://doi.org/10.1002/pro6.1172

408

Views

0

Crossref

0

Scopus

Altmetrics
Received: 04 June 2022
Revised: 30 August 2022
Accepted: 05 September 2022
Published: 22 September 2022
© 2022 The Authors. Precision Radiation Oncology published by John Wiley & Sons Australia, Ltd on behalf of Shandong Cancer Hospital & Institute.

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Return