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What do you do when the dose constraints for heart and/or lung do not pass at all in a whole breast treatment planning?

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1 Answers

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Mednet Member
Radiation Oncology · Beth Israel Deaconess Medical Center

Clinical radiation pneumonitis is rare. For example, a recent study of 191 patients treated with hypofractionation at the University of Pittsburgh found symptomatic pneumonitis in only one patient (Schad et al., PMID 36332799). Another recent study from South Korea of 1,847 patients in which 79% of ...

When treating breast cancer patients with RNI, how often do you include internal mammary nodes?

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3 Answers

Mednet Member
Mednet Member
Radiation Oncology · Beth Israel Deaconess Medical Center

Treating the internal mammary nodes (IMNs) increases heart and lung exposure; hence, the value of prophylactic IMN RT has been controversial for decades. Randomized trials suggest there may be some benefit to such treatment but disagree on which patient subgroups benefit most or not at all.A trial c...

What plan parameters do you prioritize in 3D conformal breast treatment planning?

4 Answers

Mednet Member
Mednet Member
Radiation Oncology · Varian Medical Systems/Allegheny health network

For whole breast 3D conformal RT, we contour surgical bed with 1 cm expansion for CTV and 3-5 mm for PTV.Coverage whole breast 95% of volume to 95% of dose we aim for but we accept 90 to 95.PTV (surgical bed) as above, 95% of volume to 100% of dose but accept 95 to 95 also.Volume of breast getting 1...