A phase I/II trial to evaluate the technical feasibility of partial breast irradiation with three-dimensional conformal radiation therapy in Korean women with stage I breast carcinoma

An initial report of the Korean Radiation Therapy Oncology group (KROG) study 0804

Jae Uk Jeong, Jung Han Yoon, Min Ho Park, Mee Sun Yoon, Ju Young Song, Taek Keun Nam, Woong Ki Chung, Yong Hyub Kim, Chang-Ok Suh, Sung Ja Ahn

Research output: Contribution to journalArticle

Abstract

Purpose: This prospective study was designed to verify the technical feasibility of partial breast irradiation in breast cancer patients with small breasts, which are commonly encountered in Korean women. Materials and Methods: A total of 40 Gy, administered in 10 fractions on consecutive days (one fraction per day), was prescribed to the isocenters of the fields using three-dimensional conformal radiotherapy (3-DCRT). For all patients, treatment planning and dose parameters strictly adhered to the constraints set forth in the Radiation Therapy Oncology Group (RTOG) 0319 protocol. This study was designed such that if fewer than five of the first 42 evaluable patients received unacceptable scores, the treatment would be considered reproducible. Results: Ten treatment plans (23.8%) were determined to have major variations. There was no major variation in planning target volume (PTV) coverage. The ipsilateral and contralateral breast dose limitations were not met in four (9.5%) and four cases (9.5%), respectively. Major variations in ipsilateral and contralateral lung dose limitations were observed in two cases (4.8%). Major variations in the heart and thyroid dose limitations were observed in one (2.4%) and one case (2.4%), respectively. In multivariate analysis, a ratio of PTV to ipsilateral breast volume (PTV/IB) > 0.16 was the only significant factor that statistically affected major variations. Conclusion We concluded that partial breast irradiation using 3-DCRT could not be reproduced in Korean breast cancer patients, particularly small-volumed breast surrogated as PTV/IB > 0.16. The dominant cause was the major variation in surrounding normal breast tissues.

Original languageEnglish
Pages (from-to)18-25
Number of pages8
JournalCancer Research and Treatment
Volume47
Issue number1
DOIs
Publication statusPublished - 2015 Jan 1

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Radiation Oncology
Breast
Radiotherapy
Breast Neoplasms
Conformal Radiotherapy
Thyroid Gland
Therapeutics
Multivariate Analysis
Prospective Studies
Lung

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

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title = "A phase I/II trial to evaluate the technical feasibility of partial breast irradiation with three-dimensional conformal radiation therapy in Korean women with stage I breast carcinoma: An initial report of the Korean Radiation Therapy Oncology group (KROG) study 0804",
abstract = "Purpose: This prospective study was designed to verify the technical feasibility of partial breast irradiation in breast cancer patients with small breasts, which are commonly encountered in Korean women. Materials and Methods: A total of 40 Gy, administered in 10 fractions on consecutive days (one fraction per day), was prescribed to the isocenters of the fields using three-dimensional conformal radiotherapy (3-DCRT). For all patients, treatment planning and dose parameters strictly adhered to the constraints set forth in the Radiation Therapy Oncology Group (RTOG) 0319 protocol. This study was designed such that if fewer than five of the first 42 evaluable patients received unacceptable scores, the treatment would be considered reproducible. Results: Ten treatment plans (23.8{\%}) were determined to have major variations. There was no major variation in planning target volume (PTV) coverage. The ipsilateral and contralateral breast dose limitations were not met in four (9.5{\%}) and four cases (9.5{\%}), respectively. Major variations in ipsilateral and contralateral lung dose limitations were observed in two cases (4.8{\%}). Major variations in the heart and thyroid dose limitations were observed in one (2.4{\%}) and one case (2.4{\%}), respectively. In multivariate analysis, a ratio of PTV to ipsilateral breast volume (PTV/IB) > 0.16 was the only significant factor that statistically affected major variations. Conclusion We concluded that partial breast irradiation using 3-DCRT could not be reproduced in Korean breast cancer patients, particularly small-volumed breast surrogated as PTV/IB > 0.16. The dominant cause was the major variation in surrounding normal breast tissues.",
author = "Jeong, {Jae Uk} and Yoon, {Jung Han} and Park, {Min Ho} and Yoon, {Mee Sun} and Song, {Ju Young} and Nam, {Taek Keun} and Chung, {Woong Ki} and Kim, {Yong Hyub} and Chang-Ok Suh and Ahn, {Sung Ja}",
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A phase I/II trial to evaluate the technical feasibility of partial breast irradiation with three-dimensional conformal radiation therapy in Korean women with stage I breast carcinoma : An initial report of the Korean Radiation Therapy Oncology group (KROG) study 0804. / Jeong, Jae Uk; Yoon, Jung Han; Park, Min Ho; Yoon, Mee Sun; Song, Ju Young; Nam, Taek Keun; Chung, Woong Ki; Kim, Yong Hyub; Suh, Chang-Ok; Ahn, Sung Ja.

In: Cancer Research and Treatment, Vol. 47, No. 1, 01.01.2015, p. 18-25.

Research output: Contribution to journalArticle

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AU - Nam, Taek Keun

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AU - Suh, Chang-Ok

AU - Ahn, Sung Ja

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N2 - Purpose: This prospective study was designed to verify the technical feasibility of partial breast irradiation in breast cancer patients with small breasts, which are commonly encountered in Korean women. Materials and Methods: A total of 40 Gy, administered in 10 fractions on consecutive days (one fraction per day), was prescribed to the isocenters of the fields using three-dimensional conformal radiotherapy (3-DCRT). For all patients, treatment planning and dose parameters strictly adhered to the constraints set forth in the Radiation Therapy Oncology Group (RTOG) 0319 protocol. This study was designed such that if fewer than five of the first 42 evaluable patients received unacceptable scores, the treatment would be considered reproducible. Results: Ten treatment plans (23.8%) were determined to have major variations. There was no major variation in planning target volume (PTV) coverage. The ipsilateral and contralateral breast dose limitations were not met in four (9.5%) and four cases (9.5%), respectively. Major variations in ipsilateral and contralateral lung dose limitations were observed in two cases (4.8%). Major variations in the heart and thyroid dose limitations were observed in one (2.4%) and one case (2.4%), respectively. In multivariate analysis, a ratio of PTV to ipsilateral breast volume (PTV/IB) > 0.16 was the only significant factor that statistically affected major variations. Conclusion We concluded that partial breast irradiation using 3-DCRT could not be reproduced in Korean breast cancer patients, particularly small-volumed breast surrogated as PTV/IB > 0.16. The dominant cause was the major variation in surrounding normal breast tissues.

AB - Purpose: This prospective study was designed to verify the technical feasibility of partial breast irradiation in breast cancer patients with small breasts, which are commonly encountered in Korean women. Materials and Methods: A total of 40 Gy, administered in 10 fractions on consecutive days (one fraction per day), was prescribed to the isocenters of the fields using three-dimensional conformal radiotherapy (3-DCRT). For all patients, treatment planning and dose parameters strictly adhered to the constraints set forth in the Radiation Therapy Oncology Group (RTOG) 0319 protocol. This study was designed such that if fewer than five of the first 42 evaluable patients received unacceptable scores, the treatment would be considered reproducible. Results: Ten treatment plans (23.8%) were determined to have major variations. There was no major variation in planning target volume (PTV) coverage. The ipsilateral and contralateral breast dose limitations were not met in four (9.5%) and four cases (9.5%), respectively. Major variations in ipsilateral and contralateral lung dose limitations were observed in two cases (4.8%). Major variations in the heart and thyroid dose limitations were observed in one (2.4%) and one case (2.4%), respectively. In multivariate analysis, a ratio of PTV to ipsilateral breast volume (PTV/IB) > 0.16 was the only significant factor that statistically affected major variations. Conclusion We concluded that partial breast irradiation using 3-DCRT could not be reproduced in Korean breast cancer patients, particularly small-volumed breast surrogated as PTV/IB > 0.16. The dominant cause was the major variation in surrounding normal breast tissues.

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