Dosimetric comparison of left-sided whole-breast irradiation with 3DCRT, forward-planned IMRT, inverse-planned IMRT, helical tomotherapy, and volumetric arc therapy
| Autor: | Zumrut Bahat, Adnan Yoney, Salih Gürdalli, Emine Canyilmaz, Ahmet Yilmaz, Bahar Dirican, Emel Haciislamoglu, Fatma Colak |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Organs at Risk
medicine.medical_treatment Biophysics General Physics and Astronomy Breast Neoplasms Tomotherapy Breast cancer Whole Breast Irradiation otorhinolaryngologic diseases medicine Humans Radiology Nuclear Medicine and imaging Contralateral breast Breast Radiometry Volumetric arc therapy Monitor unit business.industry Radiotherapy Planning Computer-Assisted Lumpectomy General Medicine medicine.disease Radiation therapy Radiotherapy Intensity-Modulated Nuclear medicine business |
| Zdroj: | Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB). 31(4) |
| ISSN: | 1724-191X |
| Popis: | Purpose This study evaluated the dose distribution and homogeneity of four different types of intensity-modulated radiotherapy (IMRT) in comparison with standard wedged tangential-beam three-dimensional conformal radiotherapy (3DCRT) of the left breast in patients who had undergone lumpectomy. Materials and methods Five radiotherapy treatment plans, including 3DCRT, forward-planned IMRT (for-IMRT), inverse IMRT (inv-IMRT), helical tomotherapy (HT) and volumetric-modulated arc therapy (VMAT), were created for 15 consecutive patients. Results All modalities presented similar target coverage. Target max doses were reduced with for-IMRT compared to 3DCRT, and these doses were further reduced with inv-IMRT and HT. HT resulted in the lowest max doses delivered to the heart, left anterior descending artery (LAD), and ipsilateral lung, but had higher mean, max, and low doses delivered to contralateral breast. HT resulted in increased low doses to a large volume of healthy tissue. Compared to other techniques, all inverse-planned modalities significantly improved conformity number; however, VMAT had worse homogeneity. The for-IMRT plan significantly lowered monitor unit (MU) compared to the inverse-planned techniques. Conclusion All modalities evaluated provide adequate coverage of the whole breast. For-IMRT improves target homogeneity compared with 3DCRT, but to a lesser degree than the inverse-planned inv-IMRT and HT. HT decreases the ipsilateral OAR volumes receiving higher and mean doses with an increase in the volumes receiving low doses, which is known to lead to an increased rate of radiation-induced secondary malignancies. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect