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Duma, M.N.* ; Borm, K. ; Hehr, T.* ; Piroth, M.D.* ; Gerd, F.* ; Baumann, R.* ; Combs, S.E. ; Corradini, S.* ; Dunst, J.* ; Krug, D.* ; Hörner-Rieber, J.* ; Matuschek, C.* ; Schmeel, L.C.* ; Fietkau, R.* ; Strnad, V.* ; Budach, W.*

Regional nodal irradiation in breast cancer patients: A treatment planning study of the breast cancer working group of the German society of radiation oncology.

Med. Dosim., DOI: 10.1016/j.meddos.2025.09.006 (2025)
DOI PMC
Open Access Green möglich sobald Postprint bei der ZB eingereicht worden ist.
The aim of the study was to analyze the interinstitutional differences in the planning process/approach of regional nodal irradiation (RNI) in breast cancer patients in expert centres. Based on a predefined risk constellation, the left breast and the axillary, periclavicular and internal mammarian lymph node areas had to be irradiated. The study focused on left-sided RNI. One CT dataset (free breathing) each of a regular (R) adipose (A) and a slender patient (S) were centrally selected and all target volumes (CTV: level II, III, IV + internal mammary artery chain region-IMC, left breast, PTV and OARs) were contoured according to the ESTRO recommendations. A total dose of 50.4/1.8 Gy was set as the dosage with free choice of technique/inclinic constraints. Dose files were analyzed centrally as DICOM files (CTV: D95%, D50%, D1% and V95%; OAR: D1%, Dmean, V20Gy, V30Gy, V40Gy and the absolute V95% of normal tissue outside the PTV). A total of 18 data sets were analyzed. Differences of almost 10 Gy in TV coverage were significant (p < 0.05). This was evident between patients e.g., for CTV_IMC D95%/D50% S:47.1Gy ± 1.9/50.1Gy ± 0.6; R:39.4Gy ± 8.4/47.6Gy ± 4; A:38.3Gy ± 10.4/47.9Gy ± 4.4) and PTV_IMA D95%/D50% (S:37.6Gy ± 3.9/49.7Gy ± 0.8; R:27.9Gy ± 7.8/46.9Gy ± 3.3; A:25.6Gy ± 9.7/47.5Gy ± 2.8). Patient-related dose differences were also significant for OAR`s: Dmean heart (S:4.6Gy ± 1.1; N:6.1Gy ± 1.2; A:7.9Gy ± 2.1), humeral head (S:8.3Gy ± 2.7; N:3.8Gy ± 0.7; A:6.4Gy ± 1.7), and thyroid (S:17.7Gy ± 2.7; N:14.3Gy ± 1.6; A:27.9Gy ± 4.5). Patient anatomical factors and institutional planning differences create significant dosimetric variations in breast cancer radiation therapy, emphasizing the need for personalized planning approaches that incorporate patient-specific constraints and age-dependent risk considerations.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Schlagwörter Breast Cancer ; Lymphatics ; Rni
Sprache englisch
Veröffentlichungsjahr 2025
HGF-Berichtsjahr 2025
ISSN (print) / ISBN 0958-3947
e-ISSN 1873-4022
Zeitschrift Medical dosimetry
Verlag Elsevier
Verlagsort New York, NY
Begutachtungsstatus Peer reviewed
Institut(e) Institute of Radiation Medicine (IRM)
POF Topic(s) 30203 - Molecular Targets and Therapies
Forschungsfeld(er) Radiation Sciences
PSP-Element(e) G-501300-001
DOI 10.1016/j.meddos.2025.09.006
PubMed ID 41168045
Erfassungsdatum 2025-11-03
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