Dosimetric comparison between three-dimensional conformal radiotherapy followed by electron beam boost and volumetric modulated arc therapy using concomitant boost for the heart and cardiac segments in patients with left-sided breast cancer at risk for radiation-induced cardiac toxicity
| Autor: | Yu Murakami, Yuki Murakami, Tatsuya Kamima, Masahiko Oguchi, Natsumi Abo, Taro Takahashi, Masahiro Kaneko, Masahiro Nakano, Fumiyasu Matsubayashi, Arisa Harada, Senzo Taguchi, Takeo Hashimoto, Yasuo Yoshioka |
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| Rok vydání: | 2022 |
| Předmět: |
Organs at Risk
Radiotherapy Planning Computer-Assisted Biophysics General Physics and Astronomy Breast Neoplasms Electrons Radiotherapy Dosage General Medicine Cardiotoxicity Unilateral Breast Neoplasms Humans Female Radiology Nuclear Medicine and imaging Radiotherapy Intensity-Modulated Radiotherapy Conformal Retrospective Studies |
| Zdroj: | Physica Medica. 95:126-132 |
| ISSN: | 1120-1797 |
| DOI: | 10.1016/j.ejmp.2022.02.003 |
| Popis: | We aimed to compare dosimetric parameters between three-dimensional conformal radiation therapy followed by electron beam boost (3D-CRT + EB) and volumetric modulated arc therapy using simultaneous integrated boost (SIB-VMAT) in left-sided breast cancer patients.This study included 57 patients with left-sided breast cancer who underwent SIB-VMAT. All patients had a computed tomography-based maximum heart distance of ≥ 1 cm and were prescribed a dose of 42.56 Gy/16 fractions to the planning target volume and a concomitant-boosted target dose of 53.2 Gy or 51.2 Gy. The 3D-CRT + EB plan was retrospectively created for the purpose of comparison using tangential fields with field-in-field technique followed by electron beam irradiation.The doses to the clinical target volume significantly improved in the SIB-VMAT plans. All dosimetric parameters for the left anterior descending coronary artery (LAD) and LAD middle position (LAD mid) in the SIB-VMAT plans were significantly lower than those for 3D-CRT + EB plans (P 0.01), while the doses to the heart, lung, contralateral breast and non-target tissue were decreased in the 3D-CRT + EB plans compared with those in the SIB-VMAT plans (e.g., 1.9 Gy vs. 2.9 Gy; P 0.001 for the mean dose of heart).SIB-VMAT significantly improved the dose to the target while reducing the doses to the LAD and LAD mid, whereas 3D-CRT + EB significantly decreased the doses to the heart and other organs at risk in patients with left-sided breast cancer at risk for radiation-induced coronary artery disease. |
| Databáze: | OpenAIRE |
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