Letter to the Editor concerning Tsuchiya K et al. 'Dosimetric comparison between intensity-modulated radiotherapy and standard wedged tangential technique for whole-breast radiotherapy in Asian women with relatively small breast volumes'

摘要

With great interest, we read the recent article by Tsuchiya et al. [1]. In this paper, the authors tried to identify, in the adjuvant setting after breast-conserving surgery, the optimal radiation technique for selected 25 small breast glands (median volume, 552.6 cc), comparing the dose distribution obtained with the standard wedge tangential technique (SWT), tangential-field intensity-modulated radiation therapy (T-IMRT), and 3-4 field IMRT techniques (3F-IMRT or 4F-IMRT). An improved dose distribution, a shorter treatment time, and a reduction of Radiation Therapy Oncology Group (RTOG) acute high-grade skin toxicity with the T-IMRT technique [2, 3], which can be considered a simplified form of IMRT based on two tangential fields with sub-segments, have been demonstrated [4]. In their paper, Tsuchiya et al. stated that T-IMRT can be appropriate in particular for irradiation of small breasts,because of an improvement in dose homogeneity and in the dose received by 2 % of the volume (Dmax), reducing the bilateral lung mean dose and the V20 ipsilateral lung volume, compared with the other reported techniques [1].