Assessment of Radiotherapy Toxicity in Irradiated Internal Mammary Lymph Nodes in Breast Cancer Patients

Document Type : Original Article

Authors

1 Assistant lecturer clinical oncology dept., faculity of medicine, Al-Azhar University

2 Clinical oncology department, faculity of medicine, Al-Azhar University

3 Clinical oncology depart., faculity of medicine, Al-Azhar University

4 Therapeutic Radiology and Nuclear Medicine, Al-Azhar University

Abstract

Background: breast cancer is the most prevalent cancer diagnosed in females worldwide. Radiotherapy improves survival in breast cancer patients. Consistent evidence emerges as regard benefit of inclusion of IMN (internal mammary lymph nodes). Novel radiation techniques decreased the incidence of toxicity from radiotherapy.
Aim of the work: Assessment of acute and moderately late radiation toxicity, assessing doses to normal structures, assessing overall survival and progression-free survival.
Patients and methods: this study included 41 patient received postoperative radiotherapy including internal mammary lymph nodes with Intensity-modulated radiation therapy in Al-Hussein University hospital
Results: coverage of the right-sided planning target volume and internal mammary lymph nodes was significantly higher than left-sided cases p = 0.01, 95%, p = 0.02, respectively. there was a strong, positive correlation between the volume of heart receiving 25 Gy and the volume of planning target volume receiving 95 % of the prescribed dose, p = 0.001. Significant difference skin toxicity as regard maximum dose reaching the planning target volume either ≤ 107%, 108-109% and those ≥110, P = 0.001.
Conclusion: The inclusion of the internal mammary lymph nodes in postoperative radiotherapy in breast cancer patients is well tolerable. The use of Intensity-modulated radiation therapy decreases dose to normal structures which reduce toxicity
Keywords: Breast, IMN, Radiation, Toxicity

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