Dosimetric evaluation of modern radiation therapy techniques for left breast in deep-inspiration breath-hold |
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Institution: | 2. Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan;3. Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan;4. Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan;5. Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;2. Department of Radiation Oncology, Mary Bird Perkins Cancer Center, Baton Rouge, LA, USA;3. Department of Experimental Statistics, Louisiana State University, Baton Rouge, LA, USA |
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Abstract: | PurposeThe dosimetric differences between four radiation therapy techniques for left sided whole breast irradiation were evaluated side by side in the same patient population.MethodsRadiotherapy treatment plans were retrospectively created with Accuray TomoDirect (TD), Elekta Volumetric Modulated Arc Therapy (E-VMAT), Varian RapidArc (RA) and Field-in-field (FinF) technique for 20 patients, who had received left breast irradiation during deep-inspiration breath-hold. Dose characteristics of planning target volume and organs at risk were compared.ResultsThe E-VMAT, TD and RA treatment plans had higher target coverage (V95%) than FinF plans (97.7–98.3% vs. 96.6%). The low-dose spillage to contralateral breast and lung was smaller with FinF and TD (mean 0.1 and 0.3 Gy) compared to E-VMAT and RA (mean 0.6 and 0.9 Gy). E-VMAT, RA and TD techniques were more effective than FinF in sparing left anterior descending artery (mean 4.0, 4.2 and 4.7 Gy vs. 6.1 Gy, respectively).ConclusionsIn whole breast irradiation TD, E-VMAT and RA plans generated in this study achieved higher dose coverage and sparing of organs from the high dose in the vicinity of the PTV. The advantage of calculated FinF plans is the lowest dose on contralateral organs. The choice of the technique used should be weighted by each institution taking into account the dose characteristics of each technique and its fit with patient anatomy bearing in mind the increased workload of using modulated techniques and the increased beam on time. |
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Keywords: | Breast irradiation Volumetric modulated arc therapy Tomotherapy Deep-inspiration breath-hold |
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