Hybrid VMAT-3DCRT as Breast Cancer Treatment Improvement Tool

Abstract

Radiation therapy is an important tool in the treatment of breast cancer and can play a crucial role in improving patient outcomes. For breast cancer, if the technique has been for a long time the use of 3DCRT, clinicians have seen the management evolve greatly in recent years. Field-in-field and IMRT approaches and more recently dynamic arctherapy are increasingly present. All of these approaches are constantly trying to improve tumour coverage and to preserve organs at risk by minimising the doses delivered to them. If arctherapy allows a considerable reduction of high doses received by healthy tissues, no one can deny that it also leads to an increase of low doses in tissues that would not have received any with other techniques. We propose a hybrid approach combining the robustness of the 3DCRT approach and the high technicality and efficiency of rctherapy. Statistical tests (ANOVA, Wilcoxon, determination coefficient, ROC, etc.) allow us to draw conclusions about the possibility of using the hybrid approach in certain cases (right breast, BMI > 23, age > 48, target volume > 350cc, etc.). Depending on the breast laterality and patients morphological characteristics, hybridization may prove to be a therapeutic tool of choice in the management of breast cancer in radiotherapy.