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Internal Mammary Lymph Node Irradiation after Breast Conservation Surgery: Radiation Pneumonitis versus Dose-Volume Histogram Parameters

Other Titles
 유방보존술 후 내유림프절 방사선조사: 방사선 폐렴과 체적-선량 히스토그램 변수들 
 Joo Young Kim  ;  Ik Jae Lee  ;  Chang Ok Suh  ;  Jong Dae Kim  ;  Kyoungkeun Jeong  ;  Su Jung Shim  ;  Yong Bae Kim  ;  Ki Chang Keum 
 Journal of the Korean Society for Therapeutic Radiology and Oncology, Vol.25(4) : 261-267, 2007 
Journal Title
Journal of the Korean Society for Therapeutic Radiology and Oncology(대한방사선종양학회지)
Issue Date
Breast cancer ; Internal mammary lymph node ; Radiation pneumonitis ; Radiotherapy
Purpose: To evaluate the association between radiation pneumonitis and dose-volume histogram parameters and to provide practical guidelines to prevent radiation pneumonitis following radiotherapy administered for breast cancer including internal mammary lymph nodes. Materials and Methods: Twenty patients with early breast cancer who underwent a partial mastectomy were involved in this study. The entire breast, supraclavicular lymph nodes, and internal mammary lymph nodes were irradiated with a dose of 50.4 Gy in 28 fractions. Radiation pneumonitis was assessed by both radiological pulmonary change (RPC) and by evaluation of symptomatic radiation pneumonitis. Dose-volume histogram parameters were compared between patients with grade <2 RPC and those with grade > RPC. The parameters were the mean lung dose, V10 (percent lung volume receiving equal to and more than 10 Gy), V20, V30, V40, and normal tissue complication probability (NTCP). Results: Of the 20 patients, 9 (45%) developed grade 2 RPC and 11 (55%) did not develop RPC (grade 0). Only one patient developed grade 1 symptomatic radiation pneumonitis. Univariate analysis showed that among the dose-volume histogram parameters, NTCP was significantly different between the two RPC grade groups (p<0.05). Fisher's exact test indicated that an NTCP value of 45% was appropriate as an RPC threshold level. Conclusion: This study shows that NTCP can be used as a predictor of RPC after radiotherapy of the internal mammary lymph nodes in breast cancer. Clinically, it indicates that an RPC is likely to develop when the NTCP is greater than 45%.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Suh, Chang Ok(서창옥)
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
Jeong, Kyoung Keun(정경근)
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