Planning Hybrid Intensity Modulated Radiation Therapy for Whole-breast Irradiation

Farace, Paolo; Zucca, S.; Solla, Ignazio; Fadda, Giuseppina; Durzu, Silvia; Porru, S.; Meleddu, G.; Deidda, Maria Assunta; Possanzini, M.; Orrù, Sivia; Lay, Giancarlo

doi:10.1016/j.ijrobp.2012.02.025

Cited by 32 publications

(34 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Moreover, improvements in the uniformity of dose to the target volume and conformality may be achieved by adding 2 anterior oblique IMRT beams to the 4-field hybrid technique (6-field hybrid IMRT). In a clinical trial conducted by Farace et al (21), hybrid IMRT was performed by direct aperture optimization. However, when treatment goals were not achieved by using a 4-field technique, a 6-field technique was applied.…”

Section: Dosimetric Comparison Of Left-sided Whole Breast Irradiationmentioning

confidence: 99%

Dosimetric comparison of left-sided whole breast irradiation with 3D-CRT, IP-IMRT and hybrid IMRT

et al. 2014

View full text Add to dashboard Cite

Abstract. The aim of this study was to compare the dosimetric characteristics of left-sided whole breast irradiation among 3-dimensional conformal radiotherapy (3D-CRT), 4-field inverse-planned intensity-modulated radiotherapy (IP-IMRT) and hybrid IMRT technique (combining 3D-CRT beams and IP-IMRT beams) with respect to target coverage and irradiation of organs at risk. The 3 different planning techniques were analyzed for 8 patients with left-sided breast conserving surgery. Plans were compared on the basis of planning target volume (PTV) dose conformity, homogeneity and the volumes of normal tissues treated based on dose-volume histograms (DVHs). DVHs were calculated for the PTV, heart, and the bilateral lungs, contralateral breast, and soft tissue surrounding the breast PTV (V OB ) volume. IP-IMRT and hybrid IMRT techniques comparably improved the PTV dose homogeneity and conformity (CI) significantly, compared to the conventional 3D-CRT technique (P<0.017); the IP-IMRT technique only could additionally benefit patients by decreasing the high-dose (40 Gy) volume for heart and ipsilateral lung compared with the hybrid IMRT technique (P<0.017); the hybrid IMRT plans achieved a further improvement by compromising the increase of low-dose volume (total lung V13, contralateral lung V5, heart V10 and soft tissue surrounding the breast V5) compared with IP-IMRT plans (P<0.017). Hybrid IMRT plans achieved equivalent PTV dose uniformity to IP-IMRT plans and compromised the low-dose volume and requirement of clinic resource between IP-IMRT and 3D-CRT plans, promoting it as a standard practice of left-sided breast irradiation for patients in good-ordered cardiopulmonary health.

show abstract

Section: Dosimetric Comparison Of Left-sided Whole Breast Irradiationmentioning

confidence: 99%

Dosimetric comparison of left-sided whole breast irradiation with 3D-CRT, IP-IMRT and hybrid IMRT

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Farace et al tested hybrid IMRT using semi-automated methods and use of an optimization volume as the target objective [18]. Goals were achieved in 61 patients with 2 conventional open and 2 IMRT tangents, similar to our technique.…”

Section: Discussionmentioning

confidence: 71%

Template-based breast IMRT planning for increased workload efficiency

Nguyen

Cao

Ramaseshan³

et al. 2013

Radiat Oncol

View full text Add to dashboard Cite

BackgroundTo be less resource intensive, we developed a template-based breast IMRT technique (TB-IMRT). This study aims to compare resources and dose distribution between TB-IMRT and conventional breast radiation (CBR).MethodsTwenty patients with early stage breast cancer were planned using CBR and TB-IMRT. Time to plan, coverage of volumes, dose to critical structures and treatment times were evaluated for CBR and TB-IMRT. Two sided-paired t tests were used.ResultsTB-IMRT planning time was less than CBR (14.0 vs 39.0 min, p < 0.001). Fifteen patients with CBR needed 18 MV, and 11 of these were planned successfully with TB-IMRT using 6 MV. TB-IMRT provided better homogeneity index (0.096 vs 0.124, p < 0.001) and conformity index (0.68 vs 0.59, p = 0.003). Dose to critical structures were comparable between TB-IMRT and CBR, and treatment times were also similar (6.0 vs 7.8 min, p = 0.13).ConclusionsTB- IMRT provides reduction of planning time and minimizes the use of high energy beams, while providing similar treatment times and equal plans compared to CBR. This technique permits efficient use of resources with a low learning curve, and can be done with existing equipment and personnel.

show abstract

“…Farace et al19 similarly compared tangential and non-tangential beam arrangements for hybrid IP IMRT plans utilizing a semi-automated method and a plan optimization volume set as a target objective during IP 19. The tangential beam arrangement was a four-field technique (two conventional open plus two IP IMRT tangents), and the non-tangential beam arrangement was a six-field technique where two non-tangential (anterior-oblique) IP IMRT beams were added.…”

Section: Types Of Breast Imrt Techniquesmentioning

confidence: 99%

“…Both studies demonstrated that the merits of utilizing hybrid IP IMRT lie in its largely automated process while achieving a comparable plan quality to FP FIF IMRT yet reducing planning time, reducing manual process during planning as well as dependence on dosimetrist’s expertise. The limited monitor units (MU) contribution from IP IMRT beams allowed QA to be less taxing compared to full IP IMRT 19. An added advantage of utilizing hybrid IP IMRT is the use of open fields as a main radiation source as this makes planned dosimetry less sensitive to changes in breast shape and setup inaccuracies 22…”

Section: Types Of Breast Imrt Techniquesmentioning

confidence: 99%

Intensity-modulated radiation therapy for early-stage breast cancer: is it ready for prime time?

Chan¹,

Tan²,

Tang³

2017

BCTT

View full text Add to dashboard Cite

Whole breast external beam radiotherapy (WBEBRT) is commonly used as an essential arm in the treatment management of women with early-stage breast cancer. Dosimetry planning for conventional WBEBRT typically involves a pair of tangential fields. Advancement in radiation technology and techniques has the potential to improve treatment outcomes with clinically meaningful long-term benefits. However, this advancement must be balanced with safety and improved efficacy. Intensity-modulated radiation therapy (IMRT) is an advanced technique that shows promise in improving the planning process and radiation delivery. Early data on utilizing IMRT for WBEBRT demonstrate more homogenous dose distribution with reduction in organs at risk doses. This translates to toxicities reduction. The two common descriptors for IMRT are forward-planning “fields in field” and inverse planning. Unlike IMRT for other organs, the aim of IMRT for breast planning is to achieve dose homogeneity and not organ conformality. The aim of this paper was to evaluate whether IMRT is ready for prime time based on these three points: 1) workload impact, 2) the clinical impact on the patient’s quality of life, and 3) the appropriateness and applicability to clinical practice.

show abstract

Planning Hybrid Intensity Modulated Radiation Therapy for Whole-breast Irradiation

Cited by 32 publications

References 20 publications

Dosimetric comparison of left-sided whole breast irradiation with 3D-CRT, IP-IMRT and hybrid IMRT

Dosimetric comparison of left-sided whole breast irradiation with 3D-CRT, IP-IMRT and hybrid IMRT

Template-based breast IMRT planning for increased workload efficiency

Intensity-modulated radiation therapy for early-stage breast cancer: is it ready for prime time?

Contact Info

Product

Resources

About