Dosimetric comparative study of 3DCRT, IMRT, VMAT, Ecomp, and Hybrid techniques for breast radiation therapy

Abstract

To assess and compare the dosimetric parameters obtained between three-dimensional conformal radiotherapy (3DCRT), three-dimensional field-in-field (3DFIF), 5-field intensity-modulated radiotherapy (IMRT MF5), tangential IMRT (tIMRT), tangential volumetric modulated arc therapy (tVMAT), electronic tissue compensation (Ecomp), and Hybrid treatment plans. Material and Methods: Thirty planning computed tomography datasets obtained from patients previously treated with whole breast radiation therapy (WBRT) were utilized in this study. Treatment plans were created for 3DCRT, 3DFIF, IMRT MF5, tIMRT, tVMAT, Ecomp, and Hybrid techniques using Eclipse Treatment Planning System (version 13.6) with a prescribed dose of 42.5 Gy in 16 fractions. Results: Techniques with tangential beams produced statistically significantly better organs-at-risk (OARs) dosimetry (p < 0.001). Planning target volume Homogeneity Index (HI) was found to be significantly different among all techniques (p < 0.001), with Ecomp resulting in better HI (1.061 ± 0.029). Ecomp was also observed to require relatively shorter planning time (p < 0.001). Conclusions: Techniques using tangential fields arrangements produced improved OARs dosimetry. Of all the treatment planning techniques employed in this study, Ecomp was found to be relatively easy to plan and produce acceptable dosimetry for WBRT in a short time.

A Dosimetric Study Comparing 3D-CRT vs. IMRT vs. VMAT in Left-Sided Breast Cancer Patients After Mastectomy at a Tertiary Care Centre in Eastern India

“…To ensure adequate PTV coverage and reduce hotspot to less than 107%, the Field-in-Field technique with MLCs was used with multiple subfields. The dynamic weightings used in this study were chosen to maximize PTV dose coverage and homogeneity [ 14 ]. A single anterior field with an angle of 10° away from the spinal cord was used to treat the SCF and axillary apex.…”

“…As early as 2012, Sakumi et al [ 12 ] started treating left-sided breast cancer with VMAT, concluding with the advantage of decreased treatment time. While there are multiple studies [ 13 , 14 ] for breast irradiation following breast-conserving surgery (BCS), very few studies analyzed the impact of IMRT or VMAT on PMRT. Few studies [ 15 ] compared all three modalities, some compared only two modalities, but the quantum of subjects compared was relatively low to draw clinically significant conclusions [ 16 - 20 ].…”

The use of Hybrid Techniques in Whole-Breast Radiotherapy: A Systematic Review

“… 32 , 39 , 57 In the study in which the dosimetric results of the H-IMRT and H-VMAT plans were presented, it was observed that the heart doses were similar. 52 In the comparison of H-IMRT and HT, it was observed that the heart dose of H-IMRT was lower. 41 When contralateral breast doses were examined, IMRT and VMAT doses were found to be higher than 3DCRT, H-IMRT, and H-VMAT.…”

Quantitative evaluation of radiodermatitis following whole-breast radiotherapy with various color space models: A feasibility study

“…According to recent statistics reported by the International Agency for Research on Cancer (IARC), breast cancer ranks as the second most common cancer type and is the fifth leading cause of all cancer-associated deaths in the world [1]. In 2012, approximately 1,670,000 incidences of new breast cancers were estimated, of which approximately 522,000 resulted in death [2][3][4][5]. With the remarkable technological advances being achieved in radiotherapy, this approach has gained a role in breast cancer treatment.…”