scholarly journals Cardiac Dose Control and Optimization Strategy for Left Breast Cancer Radiotherapy With Non-Uniform VMAT Technology

2021 ◽  
Vol 20 ◽  
pp. 153303382110537
Author(s):  
Jianjian Qiu ◽  
Shujun Zhang ◽  
Bo Lv ◽  
Xiangpeng Zheng
Keyword(s):  
Breast Cancer ◽  
Dose Reduction ◽  
Left Breast ◽  
Dose Verification ◽  
Delivery Time ◽  
Breast Radiotherapy ◽  
Cancer Radiotherapy ◽  
Breast Cancer Radiotherapy ◽  
Cardiac Dose ◽  
Delivery Efficiency

Purpose: A novel in-house technology “Non-Uniform VMAT (NU-VMAT)” was developed for automated cardiac dose reduction and treatment planning optimization in the left breast radiotherapy. Methods: The NU-VMAT model based on IGM (gantry MLC Movement coefficient index) was established to optimize the volumetric modulated arc therapy (VMAT) MLC movement and modulation intensity in certain gantry angles. The ESAPI embedded in Eclipse® was employed to connect TPS and the optimization program via I/O relevant DICOM RT files. The adjuvant whole-breast radiotherapy of 14 patients with left breast cancer was replanned using our NU-VMAT technology in comparison with VMAT and IMRT technology. Dosimetric parameters including D1%, D99%, and Dmean of PTV, V5, V10, and V20 of ipisilateral lung, V5, D20, D30, and Dmean of heart, monitor units (MUs), and delivery time derived from IMRT, VMAT, and NU-VMAT plans were evaluated for plan quality and delivery efficiency. The quality assurance (QA) was conducted using both point-dose and planar-dose measurements for all treatment plans. Results: The IGM−NU−VMAT curves with plan optimization (range from 50% to 147%) were converged more significantly than IGM-VMAT curves (range from 0% to 297%). The dose distribution requirements of the target and normal tissues could be met using IMRT, VMAT, or NU-VMAT; the lowest Dmean was achieved in NU-VMAT plans (5.38 ± 0.46 Gy vs 5.63 ± 0.61 Gy in IMRT and 7.95 ± 0.52 Gy in VMAT plans). Statistically significant differences were found in terms of delivery time and MU when comparing IMRT with VMAT and NU-VMAT plans ( P < .05). In comparison with IMRT plans, the MU and delivery time in NU-VMAT plans dramatically decreased by 69.8% and 28.4%, respectively. Moreover, NU-VMAT plans showed a high gamma passing rate (96.5% ± 1.11) in plane dose verification and minimal dose difference (2.4% ± 0.19) in point absolute dose verification. Conclusion: Our non-uniform VMAT facilitated the treatment strategy optimization for left breast cancer radiotherapy with dosimetric advantage in cardiac dose reduction and delivery efficiency in comparison with the conventional VMAT and IMRT.

scholarly journals EP-1702: Cardiac dose evaluation in left breast cancer radiotherapy: Direct and Helical Tomotherapy

2016 ◽  
Vol 119 ◽  
pp. S795-S796
Author(s):  
A. Fozza ◽  
L. Berta ◽  
S. Aimonetto ◽  
F. Migliaccio ◽  
A. Peruzzo Cornetto ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Helical Tomotherapy ◽  
Left Breast ◽  
Cancer Radiotherapy ◽  
Dose Evaluation ◽  
Breast Cancer Radiotherapy ◽  
Cardiac Dose

Left Breast Radiotherapy With Multi Fields Hybrid Intensity Modulated Radiotherapy (IMRT) Versus Volumetric Modulated Arc Therapy (VMAT): Balance Between Left Anterior Descending Artery Sparing and Secondary Cancer Induction Risk

2021 ◽  
Author(s):  
Xiaoyong Xiang ◽  
Zhen Ding ◽  
Kailian Kang ◽  
Zhitao Dai ◽  
Wenjue Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Volumetric Modulated Arc Therapy ◽  
Left Lung ◽  
Breast Conserving Surgery ◽  
Left Breast ◽  
High Dose ◽  
Breast Cancer Patients ◽  
Breast Radiotherapy ◽  
Breast Cancer Radiotherapy ◽  
Arc Therapy

Abstract To explore the feasibility of using Volumetric-Modulated Arc Therapy (VMAT) to protect left anterior descending branch (LAD) after breast-conserving surgery for left breast cancer. 15 left breast cancer patients after breast-conserving surgery were selected. 7F-IMRT and 2A-VMAT treatment plans were designed with Varian Eclipse TPS (13.6version). The prescriptions of PTV and PTV Boost were 43.5Gy and 49.5Gy in 15 fractions. The dosimetric parameters, OARs dose sparing and second cancer risk (SCR) were compared between the two plans using a paired t-test. The VMAT plans obtain better PTV conformity and higher mean dose. VMAT plans show a better dose distribution in high dose areas and better sparing of OARs, including left lung, heart, and LAD. The Dmax and Dmean of LAD decreased significantly in VMAT plans. The SCRs of the contralateral lung and breast significantly increased with a higher mean dose. We recommend that contouring and evaluating the dose of LAD and LAD helping structures in left breast cancer radiotherapy. SCR should be evaluated for younger patients.

Cardiac dose sparing and avoidance techniques in breast cancer radiotherapy

2014 ◽  
Vol 112 (1) ◽  
pp. 9-16 ◽  
Author(s):  
Chirag Shah ◽  
Shahed Badiyan ◽  
Sameer Berry ◽  
Atif J. Khan ◽  
Sharad Goyal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Radiotherapy ◽  
Breast Cancer Radiotherapy ◽  
Cardiac Dose ◽  
Dose Sparing

Left-sided breast cancer radiotherapy with and without breath-hold: Does IMRT reduce the cardiac dose even further?

2013 ◽  
Vol 108 (2) ◽  
pp. 248-253 ◽  
Author(s):  
Mirjam E. Mast ◽  
Loes van Kempen-Harteveld ◽  
Mark W. Heijenbrok ◽  
Yamoena Kalidien ◽  
Hans Rozema ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breath Hold ◽  
Cancer Radiotherapy ◽  
Breast Cancer Radiotherapy ◽  
Cardiac Dose
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