Target coverage and cardiopulmonary sparing with the updated ESTRO-ACROP contouring guidelines for postmastectomy radiation therapy after breast reconstruction: a treatment planning study using VMAT and proton PBS techniques

Autor:	Rachel B. Jimenez, Nicolas Depauw, Stephen Zieminski, Nikki Rosado, Michelle C. Specht, Michael Milligan, Eric C. Liao, Andrew D. Johnson
Rok vydání:	2021
Předmět:	Organs at Risk medicine.medical_specialty Advisory committee Mammaplasty Breast Neoplasms Radiation oncology medicine Proton Therapy Humans Radiology Nuclear Medicine and imaging Medical physics Radiation treatment planning Mastectomy Contouring business.industry Radiotherapy Planning Computer-Assisted Radiotherapy Dosage Hematology General Medicine Postmastectomy radiation Therapeutic Radiology Oncology Female Radiotherapy Intensity-Modulated Protons Breast reconstruction business
Zdroj:	Acta oncologica (Stockholm, Sweden). 60(11)
ISSN:	1651-226X
Popis:	The European Society for Therapeutic Radiology and Oncology Advisory Committee in Radiation Oncology Practice (ESTRO-ACROP) recently released new contouring guidelines for postmastectomy radiation therapy (PMRT) after implant-based reconstruction (IBR). As compared to prior ESTRO guidelines, the new guidelines primarily redefined the chest wall (CW) target to exclude the breast prosthesis. In this study, we assessed the impact of these changes on treatment planning and dosimetric outcomes using volumetric-modulated arc therapy (VMAT) and proton pencil-beam scanning (PBS) therapy.We performed a treatment planning study of 10 women with left-sided breast cancer who underwent PMRT after IBR. All target structures were delineated first using standard (ESTRO) breast contouring guidelines and then separately using the new (ESTRO-ACROP) guidelines. Standard organs-at-risk (OARs) and cardiac substructures were contoured. Four sets of plans were generated: (1) VMAT using standard ESTRO contours, (2) VMAT using new ESTRO-ACROP contours, (3) PBS using standard contours, and (4) PBS using new contours.VMAT plans using the new ESTRO-ACROP guidelines resulted in modest sparing of the left anterior descending coronary artery (LAD) (mean dose: 6.99 Gy standard ESTRO vs. 6.08 Gy new ESTRO-ACROP,PMRT after IBR using the new ESTRO-ACROP contouring guidelines with both VMAT and PBS therapy is associated with significant changes in exposure to several cardiopulmonary structures.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cecd85b70ff9f90206e47e816de9697c https://pubmed.ncbi.nlm.nih.gov/34313520 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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