Case study: Dosimetric comparison of VMAT, IMRT and 3DCRT techniques for left-sided breast cancer treated in deep inspiration breath-hold

Authors

  • Tereza Hanušová Czech Technical University in Prague, Faculty of Nuclear Sciences and Physical Engineering, Department of Dosimetry and Application of Ionizing Radiation, Břehová 7, 115 19 Prague 1, Czech Republic; Thomayer University Hospital, Department of Medical Physics, Vídeňská 800, 140 59 Prague 4 – Krč, Czech Republic

DOI:

https://doi.org/10.14311/AP.2023.63.0123

Keywords:

breast cancer, DIBH, treatment planning, VMAT

Abstract

The aim of this case study was to compare 3D conformal radiotherapy (3DCRT) plans for patients treated for left-sided breast cancer (whole breast without positive lymph nodes in deep inspiration breath-hold (DIBH)) to volumetric modulated arc therapy (VMAT) and intensity modulated radiation therapy (IMRT) plans. The original clinical plans used tangential field-in-field 3DCRT technique with a combination of 6 MV and 18 MV photon beams. VMAT and IMRT plans were based on several previously published techniques and used 6 MV beams. Two patients were included in this case study and 4 plans were created and compared for each one. All plans were compared in terms of tumour coverage, gradient measure and conformity index, doses to organs at risk (OARs), the volume of body receiving 5 Gy and also the number of Monitor Units (MUs). While better tumour coverage and conformity was achieved with IMRT and VMAT plans, OARs were better spared with the 3DCRT technique, which also resulted in the lowest dose bath and number of MUs.

Downloads

Download data is not yet available.

References

C. C. Popescu, I. A. Olivotto, W. A. Beckham, et al. Volumetric modulated arc therapy improves dosimetry and reduces treatment time compared to conventional intensity-modulated radiotherapy for locoregional radiotherapy of left-sided breast cancer and internal mammary nodes. International Journal of Radiation Oncology*Biology*Physics 76(1):287–295, 2010. https://doi.org/10.1016/j.ijrobp.2009.05.038

C. A. Jensen, M. Funderud, C. Lervåg. Free breathing VMAT versus deep inspiration breath-hold 3D conformal radiation therapy for early stage left-sided breast cancer. Journal of Applied Clinical Medical Physics 22(4):44–51, 2021. https://doi.org/10.1002/acm2.13208

H. Xu, G. Hatcher. Treatment planning study of volumetric modulated arc therapy and three dimensional field-in-field techniques for left chest-wall cancers with regional lymph nodes. Reports of Practical Oncology & Radiotherapy 21(6):517–524, 2016. https://doi.org/10.1016/j.rpor.2016.07.005

E. Haciislamoglu, F. Colak, C. E., et al. The choice of multi-beam IMRT for whole breast radiotherapy in early-stage right breast cancer. SpringerPlus 5:688, 2016. https://doi.org/10.1186/s40064-016-2314-2

M. Zeverino, K. Petersson, A. Kyroudi, et al. A treatment planning comparison of contemporary photon-based radiation techniques for breast cancer. Physics and Imaging in Radiation Oncology 7:32–38, 2018. https://doi.org/10.1016/j.phro.2018.08.002

J. Dean, C. Hansen, J. Westhuyzen, et al. Tangential intensity modulated radiation therapy (IMRT) to the intact breast. Journal of Medical Radiation Sciences 63(4):217–223, 2016. https://doi.org/10.1002/jmrs.185

W. L. Smith, G. Menon, N. Wolfe, et al. IMRT for the breast: a comparison of tangential planning techniques. Physics in Medicine & Biology 55(4):1231–1241, 2010. https://doi.org/10.1088/0031-9155/55/4/022

T. Virén, J. Heikkilä, K. Myllyoja, et al. Tangential volumetric modulated arc therapy technique for left-sided breast cancer radiotherapy. Radiation Oncology 10:79, 2015. https://doi.org/10.1186/s13014-015-0392-x

E. Boman, M. Rossi, M. Haltamo, et al. A new split arc VMAT technique for lymph node positive breast cancer. Physica Medica 32(11):1428–1436, 2016. https://doi.org/10.1016/j.ejmp.2016.10.012

D. Karpf, M. Sakka, M. Metzger, et al. Left breast irradiation with tangential intensity modulated radiotherapy (t-IMRT) versus tangential volumetric modulated arc therapy (t-VMAT): trade-offs between secondary cancer induction risk and optimal target coverage. Radiat Oncol 14:156, 2019. https://doi.org/10.1186/s13014-019-1363-4

ICRU. Prescribing, recording and reporting photon beam therapy. Report 50, 1993, Bethesda, USA.

ICRU. Prescribing, recording and reporting photon beam therapy (supplement to ICRU Report 50). Report 62, 1999, Bethesda, USA.

S. O. Osman, S. Hol, P. M. Poortmans, M. Essers. Volumetric modulated arc therapy and breath-hold in image-guided locoregional left-sided breast irradiation. Radiotherapy and Oncology 112(1):17–22, 2014. https://doi.org/10.1016/j.radonc.2014.04.004

V. A. Dumane, M. A. Hunt, S. Green, et al. Dosimetric comparison of volumetric modulated arc therapy, static field intensity modulated radiation therapy, and 3D conformal planning for the treatment of a right-sided reconstructed chest wall and regional nodal case. Journal of Radiotherapy 2014:835179, 2014. https://doi.org/10.1155/2014/835179

Downloads

Published

2023-05-02

How to Cite

Hanušová, T. (2023). Case study: Dosimetric comparison of VMAT, IMRT and 3DCRT techniques for left-sided breast cancer treated in deep inspiration breath-hold. Acta Polytechnica, 63(2), 123–131. https://doi.org/10.14311/AP.2023.63.0123

Issue

Section

Articles