Dosimetric Comparison of Radiation Techniques for Comprehensive Regional Nodal Radiation Therapy for Left-Sided Breast Cancer: A Treatment Planning Study
| Autor: | Jee Suk Chang, Yong Bae Kim, Jin Sup Andy Shim, Jin Sung Kim, Heejoo Ko, Min Cheol Han, Chirag Shah, Jong Geol Baek, Won Hee Lee, Ryeong Hwang Park, Jin Young Moon |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Cancer Research
medicine.medical_treatment lcsh:RC254-282 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Breast cancer Therapeutic index breast neoplasms proton therapy medicine Continuous positive airway pressure Radiation treatment planning Proton therapy radiotherapy Original Research Lung business.industry lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease Radiation therapy intensity-modulated medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis business Nuclear medicine continuous positive airway pressure Artery |
| Zdroj: | Frontiers in Oncology Frontiers in Oncology, Vol 11 (2021) |
| ISSN: | 2234-943X |
| DOI: | 10.3389/fonc.2021.645328 |
| Popis: | Background: Radiotherapy (RT) target volumes in breast cancer treatment increasingly include the internal mammary nodes, potentially increasing doses delivered to the heart and lung. The aim of this study was to compare cardiac and pulmonary doses in three-dimensional conformal radiotherapy (3DCRT), volumetric modulated arc therapy (VMAT), and proton beam therapy (PBT) with and without continuous positive airway pressure (CPAP), delivered in conventional fractionation (CF) or in hypofractionated (HF) schedules.Methods: In a dataset of 15 patients with left-sided breast cancer, partial wide tangential 3DCRT delivered in CF (50/25) and in HF (40/15) schedules as well as PBT delivered in CF and two-partial arc VMAT delivered in a HF schedule, each under CPAP and free breathing (FB) conditions were extensively examined. Target volume coverage and doses to organs-at-risk (OARs) were calculated for each technique. Outcomes were compared with one-way analysis of variance and the Bonferroni test, with P-values Results: Target volume coverage was within acceptable levels in all interventions, except for internal mammary lymph nodes D90 (99% in PBT, 90% in VMAT-CPAP, 84% in VMAT-FB, and 74% in 3DCRT). Mean heart dose (MHD) was the lowest and highest in PBT (Conclusions: PBT delivered the lowest doses to most OARs in RT for left-sided breast cancer with regional nodal irradiation. However, the dosimetric gap between proton and photon RT has narrowed substantially with modern techniques such as VMAT and CPAP; the clinical relevance of these differences is yet to be elucidated. |
| Databáze: | OpenAIRE |
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