Study | Patients (n) | Method | Axillary surgery | Axillary clips (n) | Borders of axillary Level I | Dose to Level I |
---|---|---|---|---|---|---|
Krasin et al.[3] | 25 | 2D sim/3D analysis | ALND* | 16 | Not listed | Mean dose = 32 Gy (63.5%) |
Aristei et al.[4] | 35 | 2D sim/3D analysis | ALND | 35 | Caudal border: Inferior clip | D90% = 6.75 Gy |
Cranial border: Axillary vein and 2nd clip | ||||||
Medial border: Lateral border of pectoralis minor | ||||||
Lateral border: Axillary vein | ||||||
Posterior border: Latissimus dorsi | ||||||
Takeda et al.[5] | 44 | 2D sim/3D analysis | ALND | 44 | Caudal border: Clip in latissimus dorsi at inferior level of dissection | Median V80% = 30.5% |
Cranial border: Clip in the latissimus dorsi at level of axillary vein | ||||||
Posterior border: Clip in adjacent to subscapularis vein | ||||||
Orecchia et al.[6] | 15 | 3D CRT† | SNB†† | 15 | Caudal border: SNB clip | Mean dose = 48.7% |
Cranial border Manubrium | ± 22% | |||||
35 | 3D CRT | SNB | N/A | Caudal border: Between 4th and 5th ribs | V95% = 51% ± 16% | |
Reznik et al.[7] | Cranial border: Axillary vein | Mean dose = 66% ± 13% | ||||
Medial border: Pectoralis minor | ||||||
Reed et al.[8] | 50 | 3D CRT | 32 SNB | 50 | Caudal border: Latissiumus dorsi and clavipectoral-lattisimus fascia | Mean V95% = 55% Median V95% = 53% |
18 ALND | Cranial border: Most inferior axial image of axillary artery/vein | |||||
Medial border: Pectoralis minor | ||||||
Lateral border: Medial aspect of pectoralis seratus | ||||||
Anterior border: Pectoralis minor | ||||||
Posterior border: Latissimus dorsi and subscapularis | ||||||
Alonso-Basanta et al.[9] | 20 | 3D CRT | Not reported | N/A | Caudal border: Origin of pectoralis minor 3rd – 5th ribs | V95% < 60% |
Cranial border: Pectoralis minor insertion of the coracoid process | Prone: Mean dose = 11.2 Gy | |||||
Medial border: Pectoralis minor | Supine: Mean dose = 21 Gy | |||||
Lateral border: Latissimus dorsi | ||||||
Posterior border: Latissimus dorsi | ||||||
Schlembach et al.[10] | 105 | 3D CRT | 65 SNB | 105 | Surgical clips | 85% of clips in the field |
Mean dose to clips = 98% | ||||||
39 ALND | ||||||
McCormick et al.[11] | 45 | 2D | ALND | 45 | Surgical clips | 38% of clips in field |
Chung et al.[12] | 36 | 2D or 3D CRT | SNB | 36 | Surgical clips | 94% of clips in field |
Present study | 46 | 3D CRT | SNB | 7 prone | RTOG Atlas [20] | Prone: V95% = 14% |
9 supine | Mean dose = 36% ± 31% | |||||
Mean dose to clips = 43% | ||||||
Supine: V95% = 37% (supine) | ||||||
Mean dose = 66% ± 20% | ||||||
Mean dose to clips = 95% |