Left-sided breast cancer loco-regional radiotherapy with deep inspiration breath-hold: Does volumetric-modulated arc radiotherapy reduce heart dose further compared with tangential intensity-modulated radiotherapy?
| Autor: | Trang Thanh Pham, Jacek Chojnowski, Verity Ahern, Drew Latty, Catherine Owen, Wei Wang, Kirsty Stuart, Val Gebski, K. W. Tiver, Christopher M. R. Kelly, R. Ward |
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| Rok vydání: | 2015 |
| Předmět: |
Organs at Risk
medicine.medical_treatment Left sided 030218 nuclear medicine & medical imaging Arc (geometry) Breath Holding 03 medical and health sciences 0302 clinical medicine Breast cancer medicine Unilateral Breast Neoplasms Humans Radiology Nuclear Medicine and imaging Radiation Injuries Deep inspiration breath-hold Lung business.industry Radiotherapy Planning Computer-Assisted Radiotherapy Dosage medicine.disease Radiation therapy medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Female Intensity modulated radiotherapy Radiotherapy Intensity-Modulated business Nuclear medicine |
| Zdroj: | Journal of medical imaging and radiation oncology. 60(4) |
| ISSN: | 1754-9485 |
| Popis: | Introduction Left-sided breast cancer radiotherapy has been associated with an increase in cardiac mortality. This study investigated the potential heart-sparing effect of volumetric-modulated arc radiotherapy (VMAT). We compared VMAT to tangential intensity-modulated radiotherapy (t-IMRT) in the loco-regional treatment of left-sided breast cancer, including internal mammary nodal irradiation, based on deep inspiration breath-hold (DIBH) and free-breathing (FB). Methods Radiotherapy for 15 patients was re-planned. Four plans were compared: t-IMRT-DIBH; VMAT-DIBH; t-IMRT-FB; VMAT-FB. Prescribed dose was 50 Gy in 25 fractions. T-IMRT plans were generated using tangentially orientated fields. VMAT plans were generated using two partial arcs (average arc 190°). Results Mean heart dose (MHD) was 5 ± 2.4 Gy, 5.7 ± 1.4 Gy, 9.7 ± 3.3 Gy and 8.1 ± 2.0 Gy for t-IMRT-DIBH, VMAT-DIBH, IMRT-FB and VMAT-FB respectively. The difference in MHD between IMRT-DIBH and VMAT-DIBH was not significant (P = 0.14). VMAT-DIBH significantly spared the volume of heart irradiated to doses of 20 Gy and above (p 6.3 Gy with t-IMRT-DIBH, the use of VMAT-DIBH resulted in a benefit in reducing the MHD. |
| Databáze: | OpenAIRE |
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