{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T19:08:30Z","timestamp":1762542510235,"version":"3.33.0"},"reference-count":26,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2016,3,16]],"date-time":"2016-03-16T00:00:00Z","timestamp":1458086400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Tumori"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> To evaluate the dosimetric coverage of axillary levels I, II, and III obtained with standard whole breast irradiation in 1 to 2 positive sentinel lymph nodes (SLNs) patients not submitted to axillary lymph nodes dissection (ALND), and to compare the lymph nodes areas coverage obtained with 3D conformal radiation therapy, intensity-modulated radiotherapy (IMRT), and volumetric modulated arc therapy (VMAT). <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> Patients with 1 to 2 positive SLNs undergoing breast-conserving therapy, without ALND, were included in the analysis. For each patient, 3 treatment plans were performed: a 3D conventional tangential plan, a static IMRT plan, and a volumetric IMRT, designed to encompass the entire breast parenchyma. The volumes of axillary levels I, II, and III receiving 90% and 95% (V90, V95) of the whole breast prescribed dose were evaluated. Dose-volume histograms were compared by means of the Friedman test. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Ten patients were enrolled. All defined breast volumes received &gt;95% of the prescribed dose with the 3 techniques. Median V95 for axillary level I was 26.4% (range 4.7%-61.3%) for 3D plans, 8.6% (range 0.64%-19.1%) for static IMRT plans, and 2.6% (range 0.4%-4.7%) for volumetric IMRT plans (p&lt;0.001). Median V95 for axillary level II was 5.4% (range 0%-14.6%), 1.9% (range 0%-15%), and 2.6% (range 0.4%-4.7%) for 3D, static IMRT, and volumetric IMRT, respectively (p&lt;0.001). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> Results of our analysis showed that standard 3D tangential whole breast irradiation failed to deliver a therapeutic dose to axillary levels I and II. The coverage was even lower using static and volumetric IMRT techniques. <\/jats:p><\/jats:sec>","DOI":"10.5301\/tj.5000482","type":"journal-article","created":{"date-parts":[[2016,3,18]],"date-time":"2016-03-18T08:54:25Z","timestamp":1458291265000},"page":"409-413","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Axillary Coverage by Whole Breast Irradiation in 1 to 2 Positive Sentinel Lymph Nodes in Breast Cancer Patients"],"prefix":"10.1177","volume":"102","author":[{"given":"Maria Carmen","family":"De Santis","sequence":"first","affiliation":[{"name":"Radiotherapy Unit 1, National Cancer Institute of Milan, Milan - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Bonfantini","sequence":"additional","affiliation":[{"name":"Medical Physics Unit, National Cancer Institute of Milan, Milan - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michela","family":"Dispinzieri","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit 1, National Cancer Institute of Milan, Milan - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Meroni","sequence":"additional","affiliation":[{"name":"Medical Physics Unit, National Cancer Institute of Milan, Milan - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Diletto","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit 1, National Cancer Institute of Milan, Milan - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa D.","family":"Mantero","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit 1, National Cancer Institute of Milan, Milan - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marzia","family":"Franceschini","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit 1, National Cancer Institute of Milan, Milan - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fulvia","family":"Soncini","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit 1, National Cancer Institute of Milan, Milan - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serena","family":"Di Cosimo","sequence":"additional","affiliation":[{"name":"Oncology Department, National Cancer Institute of Milan, Milan - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vito","family":"Cosentino","sequence":"additional","affiliation":[{"name":"Medical Physics Unit, National Cancer Institute of Milan, Milan - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Pignoli","sequence":"additional","affiliation":[{"name":"Medical Physics Unit, National Cancer Institute of Milan, Milan - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Lozza","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit 1, National Cancer Institute of Milan, Milan - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2016,3,16]]},"reference":[{"key":"bibr1-tj.5000482","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67887-7"},{"key":"bibr2-tj.5000482","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.90"},{"issue":"4","key":"bibr3-tj.5000482","first-page":"297","volume":"14","author":"Galimberti V","year":"2013","journal-title":"Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial. 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