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Effect of change in neck position on thyroid dose and volume in supraclavicular irradiation for breast cancer using conformal technique

Published online by Cambridge University Press:  01 March 2021

Sajeev George Pulickal ,
Nikhil Sebastian Open the ORCID record for Nikhil Sebastian [Opens in a new window] ,
Reshma Bhaskaran Open the ORCID record for Reshma Bhaskaran [Opens in a new window]  and
P Aparna
Sajeev George Pulickal
Affiliation:
Department of Radiotherapy and Oncology, Government T. D. Medical College, Vandanam, Alappuzha, Kerala688005
Nikhil Sebastian*
Affiliation:
Department of Medical Oncology, Medical Trust Hospital, Kochi, Kerala682036
Reshma Bhaskaran
Affiliation:
Department of Radiotherapy and Oncology, Government T. D. Medical College, Vandanam, Alappuzha, Kerala688005
P Aparna
Affiliation:
Department of Radiotherapy and Oncology, Government T. D. Medical College, Vandanam, Alappuzha, Kerala688005
*
Author for correspondence: Nikhil Sebastian, Department of Medical Oncology, Medical Trust Hospital, Kochi, Kerala682036. Tel: 091 854 736 8559. E-mail: drnikseban@gmail.com
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Abstract

Background and aim:

Radiation exposure to the thyroid gland during breast irradiation can lead to hypothyroidism and this can impact on the quality of life. The aim of this study was to analyse if there is any difference in the radiation dose received by the thyroid gland during supraclavicular irradiation for breast cancer, with two different neck positions—straight or when the head is turned to the contralateral side to the breast being treated, when using a conformal technique.

Materials and methods:

All patients who received chest wall/breast and supraclavicular irradiation for breast cancer in 2019 in our department were divided into two groups based on the neck position as SN (neck positioned straight) and TN (neck tilted to contralateral side). The volume of thyroid gland, the radiation dose and volume parameters for Dmax, Dmean, and V5 to V40 of the thyroid were tabulated.

Results:

There were 72 patients included in the study with a mean age of 59 years, with 39 in the SN group and 33 in the TN group. There was no significant difference in thyroid volume between the two groups. Dmean, V15, V20, V25, V30 and V35 were significantly lower in tilted neck patients as compared to straight neck patients.

Conclusion:

Neck positioned to the contralateral side of the breast primary may be recommended for conformal CT-based radiation planning.

Keywords

carcinoma breastDmeanneck positionsupraclavicular irradiationthyroid
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 2 , June 2022 , pp. 234 - 238
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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