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: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Jae-Uk
authors.initials: JU
authors.lastname: Jeong
authors.affiliation: Department of Surgery, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Jung Han
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: Department of Surgery, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Min Ho
authors.initials: MH
authors.lastname: Park
authors.affiliation: Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Mee Sun
authors.initials: MS
authors.lastname: Yoon
authors.affiliation: Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Ju-Young
authors.initials: JY
authors.lastname: Song
authors.affiliation: Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Taek-Keun
authors.initials: TK
authors.lastname: Nam
authors.affiliation: Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Woong-Ki
authors.initials: WK
authors.lastname: Chung
authors.affiliation: Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Yong-Hyub
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Chang-Ok
authors.initials: CO
authors.lastname: Suh
authors.affiliation: Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Sung-Ja
authors.initials: SJ
authors.lastname: Ahn
keywords: Breast neoplasms; Conformal radiotherapy; Partial breast irradiation