Optimizing XXXX treatment efficacy with intensity-modulated radiotherapy.

@entity1 @entity82 @entity137 @entity0 @entity5026 @entity272
PURPOSE: To present our clinical experience using intensity-modulated radiation therapy (IMRT) to improve dose uniformity and treatment efficacy in @entity1 with @entity0 treated with breast-conserving therapy. METHODS AND MATERIALS: A total of 281 @entity1 with Stage 0, I, and II @entity0 treated with breast-conserving therapy received whole breast RT after lumpectomy using our static, multileaf collimator (sMLC) IMRT technique. The technical and practical aspects of implementing this technique on a large scale in the clinic were analyzed. The clinical outcome of @entity1 treated with this technique was also reviewed. RESULTS: The median time required for three-dimensional alignment of the tangential fields and dosimetric IMRT planning was 40 and 45 min, respectively. The median number of sMLC segments required per @entity1 to meet the predefined dose-volume constraints was 6 (range 3-12). The median percentage of the treatment given with open fields (no sMLC segments) was 83% (range 38-96%), and the median treatment time was <10 min. The median volume of breast receiving 105% of the prescribed dose was 11% (range 0-67.6%). The median breast volume receiving 110% of the prescribed dose was 0% (range 0-39%), and the median breast volume receiving 115% of the prescribed dose was also 0%. A total of 157 @entity1 (56%) experienced Radiation Therapy Oncology Group Grade 0 or I acute @entity137 ; 102 @entity1 (43%) developed @entity137 and only 3 (1%) experienced @entity137 . The cosmetic results at 12 months (95 @entity1 analyzable) were rated as excellent/good in 94 @entity1 (99%). No @entity272 , significant @entity82 , or persistent @entity5026 was noted. CONCLUSION: The use of intensity modulation with our sMLC technique for tangential whole breast RT is an efficient method for achieving a uniform and standardized dose throughout the whole breast. Strict dose-volume constraints can be readily achieved resulting in both uniform coverage of breast tissue and a potential reduction in acute and chronic @entity137 . Because the median number of sMLC segments required per @entity1 is only 6, the treatment time is equivalent to conventional wedged-tangent treatment techniques. As a result, widespread implementation of this technology can be achieved with minimal imposition on clinic resources and time constraints.
