Dosimetric Investigation of FIF, VMAT, IMRT, H-VMAT, and H-IMRT Planning Techniques in Breast Cancer Radiotherapy

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SARAÇ CANBOLAT H., Demircan N. V., ÇATLI DİNÇ S., ŞENTÜRK M. E., Bora H.

Turk Onkoloji Dergisi, cilt.38, sa.1, ss.45-51, 2023 (ESCI, Scopus, TRDizin)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 38 Sayı: 1
  • Basım Tarihi: 2023
  • Doi Numarası: 10.5505/tjo.2022.3740
  • Dergi Adı: Turk Onkoloji Dergisi
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Academic Search Premier, CINAHL, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.45-51
  • Anahtar Kelimeler: Breast cancer, field-in-field, hybrid planning technique, intensity modulate, radiotherapy, volumetric-modulated arc therapy
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Sağlık Bilimleri Üniversitesi Adresli: Hayır

Özet

OBJECTIVE It is aimed to compare the hybrid radiotherapy (RT) plans according to three-dimensional field-in-field (FIF), intensity-modulated RT (IMRT), and volumetric-modulated arc therapy (VMAT) techniques in RT applied to the whole breast volume after breast-conserving surgery. METHODS Based on the simulation images of 31 consecutive patients who received whole breast RT, a dose of 50 Gy (25 fractions) was prescribed to the planned treatment volume (PTV) with 6 MV X-rays, five new plans were created, respectively (FIF, VMAT, IMRT, H-VMAT, and H-IMRT). Homogeneity criteria for PTV, volume-dose criteria for peripheral critical organs, and MU values of the plans were evaluated separately for each plan. Subgroup analyses were performed for the left-and right-sided patients. RESULTS Both hybrid plans produced a more homogeneous plan at the target volume compared to the other three techniques (HI; 0.14, 0.14, 0.16, 0.12, and 0.13, p<0.001, respectively). Again, smaller values for D2% were obtained with both hybrid techniques (53.25, 53.24, 53.8, 52.41, and 52.47 Gy, respectively, p<0.001). The mean heart dose for the left-sided irradiations was 3.54, 3.40, 4.33, 3.49, and 3.79 Gy for the five techniques, respectively (p=0.029). Compared with FIF with the other four techniques for the left-sided irradiations, the LAD D 10% value was significantly reduced (p<0.001). CONCLUSION Hybrid plans provide a more homogeneous dose distribution compared to the use of other techniques alone, while at the same time, it allows reducing the ipsilateral lung and heart doses.