title: A prospective cohort study on postoperative radiotherapy with TomoDirect using simultaneous integrated boost technique in early breast cancer.
abstract: OBJECTIVE
  To evaluate the technical feasibility and toxicity of TomoDirect in breast cancer patients who received radiotherapy after breast-conserving surgery.
  
  
  METHODS
  155 consecutive patients with breast carcinoma in situ or T1-2 breast cancer with negative lymph node received breast irradiation with TomoDirect using simultaneous integrated boost technique in the prospective cohort study. A radiation dose of 50.4 Gy and 57.4 Gy in 28 fractions was prescribed to the ipsilateral breast and tumor bed, respectively. Dosimetric parameters of target and organ at risk and acute complication were assessed prospectively.
  
  
  RESULTS
  The mean dose for the tumor bed is 58.90 Gy. The mean values of V54.53Gy (95% of the prescribed dose), V63.14Gy (110% of the prescribed dose), and V66.01Gy (115% of the prescribed dose) were 99.97%, 1.26%, and 0%, respectively. The mean value of radiation conformality index was 1.01. The mean value of radical dose homogeneity index was 0.89. The average dose irradiated to the ipsilateral lung, heart, and contralateral breast was 4.72 Gy, 1.09 Gy, and 0.19 Gy, respectively. The most common toxicity was dermatitis. During breast irradiation, grade 2 and 3 dermatitis occurred in 41 (26.5%) and 6 (3.9%) of the 155 patients, respectively. Two patients had arm lymphedema during breast irradiation. Two patients had grade 2 pneumonitis 1 month after breast irradiation.
  
  
  CONCLUSIONS
  Radiotherapy using TomoDirect in early breast cancer patients showed acceptable toxicities and optimal results in terms of target coverage and organ at risk sparing.
authors.affiliation: Department of Radiation Oncology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea, 442-723, 93-6, Ji-dong, Paldal-gu, Suwon, Kyeonggi-do, Republic of Korea. quepaso@catholic.ac.kr.
authors.forename: Hyo Chun
authors.initials: HC
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea, 442-723, 93-6, Ji-dong, Paldal-gu, Suwon, Kyeonggi-do, Republic of Korea. kimandre@catholic.ac.kr.
authors.forename: Sung Hwan
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Surgery, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. yjsuh@catholic.ac.kr.
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Suh
authors.affiliation: Department of Radiation Oncology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea, 442-723, 93-6, Ji-dong, Paldal-gu, Suwon, Kyeonggi-do, Republic of Korea. mjwithu@catholic.ac.kr.
authors.forename: Mi Joo
authors.initials: MJ
authors.lastname: Chung
authors.affiliation: Department of Radiation Oncology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea, 442-723, 93-6, Ji-dong, Paldal-gu, Suwon, Kyeonggi-do, Republic of Korea. eorb91@nate.com.
authors.forename: Dae Gyu
authors.initials: DG
authors.lastname: Kang
authors.affiliation: Department of Hospital Pathology, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. chj0103@catholic.ac.kr.
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Choi
authors.affiliation: Department of Radiation Oncology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea, 442-723, 93-6, Ji-dong, Paldal-gu, Suwon, Kyeonggi-do, Republic of Korea. koppul@catholic.ac.kr.
authors.forename: Jong Hoon
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D058958:Organs at Risk / Q000528:radiation effects*; D011182:Postoperative Care; D011379:Prognosis; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D055815:Young Adult