An efficient treatment planning approach to reduce the critical organ dose in volumetric modulated arc therapy for synchronous bilateral breast cancer patients

Lin, Yining; Shueng, Pei‐Wei; Lin, Hsueh-Yi; Tien, Hui‐Ju; Lai, Lu-Han

doi:10.1016/j.radphyschem.2020.108957

Cited by 2 publications

(6 citation statements)

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“… 8 Contrary to the suggestion of some studies that a dual‐isocentric solution may be necessary for very large bilateral breasts and bilateral lymph node‐positive breasts, this study shows that there is no significant difference in PTV coverage between single‐ and dual‐isocenter cases for SSBC patients without lymph nodes. 3 , 13 …”

Section: Discussionmentioning

confidence: 99%

“…Breast cancer is one of the most common cancers in women, and many patients are diagnosed with breast cancer every year 1 . Approximately 2% of all patients with breast cancer are diagnosed with synchronous bilateral breast cancer (SBBC) 2,3 . SBBC, including two or more malignant tumors of the bilateral breast, is rare and complex, but the number of SBBC diagnoses is increasing steadily with the increase in breast cancer cases.…”

Section: Introductionmentioning

confidence: 99%

“… 1 Approximately 2% of all patients with breast cancer are diagnosed with synchronous bilateral breast cancer (SBBC). 2 , 3 SBBC, including two or more malignant tumors of the bilateral breast, is rare and complex, but the number of SBBC diagnoses is increasing steadily with the increase in breast cancer cases. Further, it is more common in younger patients and is characterized by tumors of a smaller size than those related to unilateral breast cancer (UBC).…”

Section: Introductionmentioning

confidence: 99%

“…The difficulty of formulating a treatment plan is compounded if the planning target volume (PTV) includes axillary lymph nodes and/or internal mammary gland nodes. 3 , 4 In such cases, organs at risk (OARs) cannot be spared adequately in the direction of the PTV if traditional half‐field RT techniques, for example, 2D RT or 3D conformal RT (3DCRT) with tangential beam irradiation, are used. 5 , 6 Further, the application of these techniques on both sides may result in a high maxima above the sternum, where the tangential fields overlap and produce unacceptably low target coverage.…”

Section: Introductionmentioning

confidence: 99%

“…Radiotherapy (RT) planning for SBBC treatment is more challenging than RT planning for UBC. The difficulty of formulating a treatment plan is compounded if the planning target volume (PTV) includes axillary lymph nodes and/or internal mammary gland nodes 3,4 . In such cases, organs at risk (OARs) cannot be spared adequately in the direction of the PTV if traditional half‐field RT techniques, for example, 2D RT or 3D conformal RT (3DCRT) with tangential beam irradiation, are used 5,6 .…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the dosimetric and radiobiological parameters in four radiotherapy regimens for synchronous bilateral breast cancer

Kang

Lee

et al. 2022

J Applied Clin Med Phys

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This study is to investigate the optimal treatment option for synchronous bilateral breast cancer (SBBC) by comparing dosimetric and radiobiological parameters of intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) plans using single and dual isocenters. Twenty patients with SBBC without lymph node involvement were selected retrospectively. Four treatment plans were generated for each patient using the Eclipse treatment planning system (Varian Medical System, Palo Alto, CA, USA) following two delivery techniques with two isocenter conditions-IMRT using a single isocenter (IMRT_Iso1), VMAT using a single isocenter (VMAT_Iso1), IMRT using dual isocenters (IMRT_Iso2), and VMAT using dual isocenters (VMAT_Iso2). A dose of 42.56 Gy in 16 fractions was prescribed for the planning target volume (PTV). All plans were calculated using the Acuros XB algorithm and a photon optimizer for a 6-MV beam of a Vital Beam linear accelerator. PTV-related dosimetric parameters were analyzed. Further, the homogeneity index, conformity index, and conformation number were computed to evaluate plan quality. Dosimetric parameters were also measured for the organs at risk (OARs). In addition, the equivalent uniform dose corresponding to an equivalent dose related to a reference of 2 Gy per fraction, the tumor control probability, and the normal tissue complication probability were calculated based on the dosevolume histogram to investigate the radiobiological impact on PTV and OARs. IMRT_Iso1 exhibited similar target coverage and a certain degree of dosimetric improvement in OAR sparing compared to the other techniques. It also exhibited some radiobiological improvement, albeit insignificant. Although IMRT_Iso1 significantly increased monitor unit compared to VMAT_Iso1, which is the best option in terms of delivery efficiency, there was only a 22% increase in delivery time. Therefore, in conclusion, IMRT_Iso1, the complete treatment of which can be completed using a single setup, is the most effective method for treating SBBC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%