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.
Dual partial arc volumetric-modulated arc therapy: The game changer for accelerated hypofractionated whole-breast radiotherapy with simultaneous integrated tumor cavity boost in early breast cancer - A comparative dosimetric study with single partial arc volumetric-modulated arc therapy