scholarly journals Dosimetric Comparison of IMRT, Hybrid IMRT and Hybrid VMAT For Early Stage Right-Sided Breast Cancer

2021 ◽  
Author(s):  
Suyan Bi ◽  
Rui Zhu ◽  
Zhitao Dai
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Absolute Risk ◽  
Organs At Risk ◽  
Volumetric Modulated Arc Therapy ◽  
Intensity Modulated Radiotherapy ◽  
Contralateral Breast ◽  
Early Stage Breast Cancer ◽  
Ipsilateral Lung ◽  
Contralateral Lung

Abstract Purpose This study aimed to evaluate the clinical impact of hybrid intensity-modulated radiotherapy (IMRT) and hybrid volumetric-modulated arc therapy (VMAT) for early-stage breast cancer, including plan quality and second cancer risk (SCR). Methods Three different plans were designed in full IMRT, hybrid IMRT, and hybrid VMAT for each of eight patients with early-stage breast cancer. Target quality, organs at risk (OARs) sparing, and SCR were compared among the three plans. Results Compared with the hybrid IMRT, full IMRT showed deterioration in terms of D2% of simultaneous integrated boost (SIB), V10 of ipsilateral lung, and excess absolute risk (EAR) to contralateral lung and esophagus. The homogeneity index (HI) of SIB, V5 of ipsilateral lung and combined lung, the Dmax and Dmean of the esophagus, the EAR to contralateral breast and lung, and the EAR to the esophagus with hybrid VMAT dramatically increased by 12.5%, 19.49%, 18.87%, 90.59%, 167.69%, 50.14%, 264.68%, and 160.95%, respectively (p = 0.022; 0.040; 0.044; 0.041; 0.003; 0.020; 0.000; 0.003). The EAR to contralateral breast and contralateral lung by full IMRT was significantly decreased compared with the hybrid VMAT (26.97%, p = 0.033; 50.01%, p = 0.026). Conclusion The results confirmed that hybrid IMRT could achieve better target quality and OARs sparing than full IMRT and hybrid VMAT for early-stage right breast cancer. Hybrid IMRT was the best treatment option, while hybrid VMAT performed the worst among the three plans in terms of SCR to peripheral OARs.

scholarly journals Prophylactic irradiation to the contralateral breast for BRCA mutation carriers with early-stage breast cancer

2019 ◽  
Vol 30 (3) ◽  
pp. 412-417 ◽  
Author(s):  
E. Evron ◽  
A.M. Ben-David ◽  
H. Goldberg ◽  
G. Fried ◽  
B. Kaufman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Brca Mutation ◽  
Contralateral Breast ◽  
Early Stage Breast Cancer ◽  
Mutation Carriers ◽  
Brca Mutation Carriers ◽  
Prophylactic Irradiation

Feasibility of Preoperative Volumetric-Modulated Arc Therapy for Early Stage Breast Cancer

2014 ◽  
Vol 45 (2) ◽  
pp. 162
Author(s):  
Krista Bota ◽  
Stewart Gaede ◽  
Scott Karnas ◽  
Eugene Wong ◽  
Wong Eugene ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Volumetric Modulated Arc Therapy ◽  
Early Stage Breast Cancer ◽  
Arc Therapy

scholarly journals A Dosimetric and Radiobiological Evaluation of VMAT Following Mastectomy for Patients With Left-sided Breast Cancer

2021 ◽  
Author(s):  
Yun Zhang ◽  
Yuling Huang ◽  
Shenggou Ding ◽  
Xingxing Yuan ◽  
Yuxian Shu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Chest Wall ◽  
Treatment Time ◽  
Absolute Risk ◽  
Statistical Significance ◽  
Conformity Index ◽  
Delivery Time ◽  
Ipsilateral Lung ◽  
Contralateral Lung

Abstract Background: To compare the dosimetric normal tissue complication probability (NTCP), secondary cancer complication probabilities (SCCP), and excess absolute risk (EAR) differences of volumetric modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) for left-sided breast cancer after mastectomy. Methods and materials: Thirty patients with left-sided breast cancer treated with post-mastectomy radiation therapy (PMRT) were randomly enrolled in this study. Both IMRT and VMAT treatment plans were created for each patient. Planning target volume (PTV) doses for the chest wall and internal mammary nodes, PTV1, and PTV of the supraclavicular nodes, PTV2, of 50 Gy were prescribed in 25 fractions. The plans were evaluated based on PTV1 and PTV2 coverage, homogeneity index (HI), conformity index, conformity number (CN), dose to organs at risk, NTCP, SCCP, EAR, number of monitors units, and beam delivery time. Results: VMAT resulted in more homogeneous chest wall coverage than did IMRT. The percent volume of PTV1 that received the prescribed dose of VMRT and IMRT was 95.9 ± 1.2% and 94.5 ± 1.6%, respectively (p < 0.001). The HI was 0.11 ± 0.01 for VMAT and 0.12 ± 0.02 for IMRT, respectively (p = 0.001). The VMAT plan had better conformity (CN: 0.84 ± 0.02 vs. 0.78 ± 0.04, p < 0.001) in PTV compared with IMRT. As opposed to IMRT plans, VMAT delivered a lower mean dose to the ipsilateral lung (11.5 Gy vs 12.6 Gy) and heart (5.2 Gy vs 6.0 Gy) and significantly reduced the V5, V10, V20, V30, and V40 of the ipsilateral lung and heart; only the differences in V5 of the ipsilateral lung did not reach statistical significance (p = 0.409). Although the volume of the ipsilateral lung and heart encompassed by the 2.5 Gy isodose line (V2.5) was increased by 6.7% and 7.7% (p < 0.001, p = 0.002), the NTCP was decreased by 0.8% and 0.6%, and SCCP and EAR were decreased by 1.9% and 0.1% for the ipsilateral lung. No significant differences were observed in the contralateral lung/breast V2.5, V5, V10, V20, mean dose, SCCP, and EAR. Finally, VMAT reduced the number of monitor units by 31.5% and the treatment time by 71.4%, as compared with IMRT. Conclusions: Compared with IMRT, VMAT is the optimal technique for PMRT patients with left-sided breast cancer due to better target coverage, a lower dose delivered, NTCP, SCCP, and EAR to the ipsilateral lung and heart, similar doses delivered to the contralateral lung and breast, fewer monitor units and a shorter delivery time.

scholarly journals A dosimetric and radiobiological evaluation of VMAT following mastectomy for patients with left-sided breast cancer

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yun Zhang ◽  
Yuling Huang ◽  
Shenggou Ding ◽  
Xingxing Yuan ◽  
Yuxian Shu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Chest Wall ◽  
Treatment Time ◽  
Absolute Risk ◽  
Statistical Significance ◽  
Conformity Index ◽  
Delivery Time ◽  
Ipsilateral Lung ◽  
Contralateral Lung

Abstract Background To compare the dosimetric, normal tissue complication probability (NTCP), secondary cancer complication probabilities (SCCP), and excess absolute risk (EAR) differences of volumetric modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) for left-sided breast cancer after mastectomy. Methods and materials Thirty patients with left-sided breast cancer treated with post-mastectomy radiation therapy (PMRT) were randomly enrolled in this study. Both IMRT and VMAT treatment plans were created for each patient. Planning target volume (PTV) doses for the chest wall and internal mammary nodes, PTV1, and PTV of the supraclavicular nodes, PTV2, of 50 Gy were prescribed in 25 fractions. The plans were evaluated based on PTV1 and PTV2 coverage, homogeneity index (HI), conformity index, conformity number (CN), dose to organs at risk, NTCP, SCCP, EAR, number of monitors units, and beam delivery time. Results VMAT resulted in more homogeneous chest wall coverage than did IMRT. The percent volume of PTV1 that received the prescribed dose of VMRT and IMRT was 95.9 ± 1.2% and 94.5 ± 1.6%, respectively (p < 0.001). The HI was 0.11 ± 0.01 for VMAT and 0.12 ± 0.02 for IMRT, respectively (p = 0.001). The VMAT plan had better conformity (CN: 0.84 ± 0.02 vs. 0.78 ± 0.04, p < 0.001) in PTV compared with IMRT. As opposed to IMRT plans, VMAT delivered a lower mean dose to the ipsilateral lung (11.5 Gy vs 12.6 Gy) and heart (5.2 Gy vs 6.0 Gy) and significantly reduced the V5, V10, V20, V30, and V40 of the ipsilateral lung and heart; only the differences in V5 of the ipsilateral lung did not reach statistical significance (p = 0.409). Although the volume of the ipsilateral lung and heart encompassed by the 2.5 Gy isodose line (V2.5) was increased by 6.7% and 7.7% (p < 0.001, p = 0.002), the NTCP was decreased by 0.8% and 0.6%, and SCCP and EAR were decreased by 1.9% and 0.1% for the ipsilateral lung. No significant differences were observed in the contralateral lung/breast V2.5, V5, V10, V20, mean dose, SCCP, and EAR. Finally, VMAT reduced the number of monitor units by 31.5% and the treatment time by 71.4%, as compared with IMRT. Conclusions Compared with IMRT, VMAT is the optimal technique for PMRT patients with left-sided breast cancer due to better target coverage, a lower dose delivered, NTCP, SCCP, and EAR to the ipsilateral lung and heart, similar doses delivered to the contralateral lung and breast, fewer monitor units and a shorter delivery time.

PO-0976: Feasibility of preoperative volumetric-modulated arc therapy for early stage breast cancer

2014 ◽  
Vol 111 ◽  
pp. S136
Author(s):  
K. Bota ◽  
S. Gaede ◽  
S. Karnas ◽  
E. Wong ◽  
B. Yaremko ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Volumetric Modulated Arc Therapy ◽  
Early Stage Breast Cancer ◽  
Arc Therapy
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