A dosimetric comparison of double-arc volumetric arc therapy, step-shoot intensity modulated radiotherapy and 3D-CRT for left-sided breast cancer radiotherapy after breast-conserving surgery.
Technol Health Care
; 25(5): 851-858, 2017 Oct 23.
Article
em En
| MEDLINE
| ID: mdl-29103057
ABSTRACT
OBJECTIVE:
To compare the dosimetric and efficiency differences for left-sided breast cancer radiotherapy after breast-conserving surgery among three different planning techniques double-arc volumetric-modulate arc therapy (VMAT), step-shoot intensity-modulated radiotherapy (sIMRT) and three-dimensional conformal radiation therapy (3D-CRT). MATERIALS ANDMETHODS:
A total of 17 female patients with left-sided breast cancer who underwent breast-conserving surgery were selected; the prescription doses were 50 Gy in 25 fractions. For every patient VMAT, sIMRT and 3D-CRT plans were generated within the Monaco treatment planning system for an Axesse™ accelerator equipped with the Agility MLC. The Conformity Index (CI), the Homogeneity Index (HI), the dose volume histogram (DVH) parameters for the organs at risk and the delivery efficiency were evaluated.RESULTS:
The VMAT plans showed on average higher CI of PTV (0.77 ± 0.03) than both sIMRT (0.68 ± 0.02) and 3D-CRT (0.55 ± 0.04) plans (P< 0.05). The HI values in the VMAT, sIMRT and 3D-CRT plans were 0.10 ± 0.01 0.09 ± 0.01 and 0.13 ± 0.01 (P> 0.05), respectively, and the differences among the three techniques were not statistically significant. In the ipsilateral lung, the VMAT plans showed lower Dmean, V30, V20, and V10 than the sIMRT and 3D-CRT (P< 0.05); however, there was no significant difference in V5. In the heart, the VMAT plans had lower V30 and V20 than the sIMRT and 3D-CRT plans (P< 0.05), but there was no significant difference in the Dmean and V5. In the contralateral lung, the VMAT plans showed higher Dmean and V5 than sIMRT and 3D-CRT (P< 0.05). In the contralateral breast, the VMAT plans had a higher V5 than the sIMRT and 3D-CRT plans (P< 0.05). The VMAT plans had higher MU's than sIMRT and 3D-CRT, while the treatment times were lower than that of sIMRT.CONCLUSION:
For left-sided breast cancer radiotherapy after breast-conserving surgery, the VMAT plans had a better CI than the sIMRT and 3D-CRT plans. The VMAT and the sIMRT plans had better HI than the 3D-CRT plans, but no significant difference was observed between VMAT and sIMRT.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Planejamento da Radioterapia Assistida por Computador
/
Radioterapia Conformacional
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Radioterapia de Intensidade Modulada
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Neoplasias Unilaterais da Mama
Limite:
Adult
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
Technol Health Care
Assunto da revista:
ENGENHARIA BIOMEDICA
/
SERVICOS DE SAUDE
Ano de publicação:
2017
Tipo de documento:
Article
País de publicação:
HOLANDA
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HOLLAND
/
NETHERLANDS
/
NL
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PAISES BAJOS
/
THE NETHERLANDS