Dosimetric Analysis of Three Different Radiotherapy Techniques in Patients with Breast Cancer and Their Impact on Organs at Risk (OAR)

Abstract In terms of breast cancer radiation treatment, it has radiation using the 3D-Conformal Radiotherapy (3D-CRT) technique and the continuation of the 3D-CRT technique, namely the Intensity Modulated Radiation Therapy (IMRT) technique. This study aims to evaluate the dosage aspects of PTV and OAR between the 3D-CRT and IMRT techniques in cases of left breast cancer with hypofractionation using the Deep Inspiration Breath Hold (DIBH) method using the Conformity Index (CI) and Homogeneity Index (H.I.) and H.I. organ at risk uses tolerance limits. This type of research is comparative quantitative with ten samples with primary data conducted at Siloam T.B. Hospital. Simatupang from November 2019 to April 2020. The research was carried out in the form of radiation planning with 3D-CRT techniques and IMRT techniques, and the results of planning both techniques were evaluated between 3D-CRT techniques and IMRT techniques through PTV evaluations using CI and H.I. values. Furthermore, the organs at risk use tolerance limits on each organ. The results showed the assessment between 3D-CRT and IMRT on PTV and organs at risk received different doses. The PTV shows the CI value, which is almost the same as the difference of 0.034, and there is a slight difference in H.I. with an average value in the IMRT technique of 0.07 and 3D-CRT of 0.11, and it can be seen that the IMRT is slightly superior because the excellent H.I. value is the closest to 0. Then at the dose of organ at risk received by the sample, the 3D-CRT technique is slightly superior by obtaining a lower dose that obtains the difference in the heart by 0.53%, lung by 3.46%, spinal cord by 6.51 Gy, esophagus at 4.5 Gy, and larynx at 5.18 Gy.

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The radiation doses to the heart and the left anterior descending coronary artery for various modes of radiation treatment of the breast cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e12092 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e12092-e12092

Author(s):

Elizaveta Maslyukova ◽

Luiza Korytova ◽

Anna Bondarenko ◽

Razifa Zhabina ◽

Oleg Korytov ◽

...

Keyword(s):

Breast Cancer ◽

At Risk ◽

Cancer Patients ◽

Supine Position ◽

Radiation Treatment ◽

Organs At Risk ◽

Free Breathing ◽

Breast Cancer Patients ◽

Heart Volume ◽

Treatment Plans

e12092 Background: The comparison of the radiation load to the organs at risk for three modes of radiation treatment of the breast cancer patients. Methods: The research includes the dosimetric radiation treatment plans for the 20 breast cancer patients with the left-side localization. They all underwent a computed tomography (CT) scan in standard supine position in free-breathing (FB), supine position with Active Breathing Control (ABC) device in deep inspiratory breath hold, and prone position in free-breathing (PP). Three-dimensional treatment plans were made for all 3 CTs. The dose valuations for 3D-planning were carried out for three CT- series. For each mode of radiation, the doze-volume parameters of organs at risk were estimated. Results: For all cases the contoured heart volume varied from 477 см3 - 1056 см3, with medium volume 769 см3. The best marks such as V25heart, medium doses to the heart and LAD, were achieved with on ABC methods (V25heart 4,26%, Dmean heart 3,13Gy, DmeanLAD 13,8Gy) in comparison FB (V25heart 9,49%, Dmean heart 4,97Gy, DmeanLAD 19,55Gy) and PP (V25heart 12,8%, Dmean heart 9,06Gy, DmeanLAD 24,18 Gy) (V25heart P = 0.00153, Dmean heart: P =0,000; Dmean LAD: P = 0.00088), when both the breast and the axillary nodes were included in the volume. The advantage of the dosimetric indexes for FB and ABC did not change while axillary and supraclavicular nodes were added to the radiation volume ABC (V25heart 3,49%, Dmean heart 3,08Gy, DmeanLAD 13,88Gy) in comparison with FB methods (V25heart 7,91%, Dmean heart 4,99Gy, DmeanLAD 19,89Gy) (V25heart P = 0.00205, Dmean heart: P =0,004; Dmean LAD: P = 0.03). Conclusions: Radiation treatment in the position on the back with controlled delay of breath on inspiration height contributed to the statistically significant reduction of the heart volume exposed to more than 25 Gy (V25heart), mean dose to the heart and mean dose to LAD.

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The Advantages of Active Breathing Coordinator Device During Left-Sided Breast Cancer Radiation Therapy: A Dosimetric Comparison Study

10.21203/rs.3.rs-40352/v1 ◽

2020 ◽

Author(s):

Nadia Pasinetti ◽

Lilia Bardoscia ◽

Luigi Spiazzi ◽

Barbara Ghedi ◽

Sara Pedretti ◽

...

Keyword(s):

Breast Cancer ◽

At Risk ◽

Side Effects ◽

Organs At Risk ◽

Left Lung ◽

Normal Tissue Complication Probability ◽

Left Breast ◽

Breath Hold ◽

Deep Inspiration Breath Hold ◽

Dose Volume Histograms

Abstract Background: Radiotherapy (RT) improves local control and survival in breast cancer (BC) patients. However, risk of heart and lung side effects after post-operative left breast RT for breast cancer remain despite technological and technical RT advances. In a retrospective cohort we investigated if Active Breathing Coordinator (ABC) device can reduce risk of cardiopulmonary morbidity.Methods: we performed two different dosimetric analyses by Normal Tissue Complication Probability (NTCP) and Bio-Dose-Volume Histograms (Bio-DVH) in order to determine whether left breast RT using moderating deep inspiration breath-hold (mDIBH) with the Active Breathing Coordinator (ABC) device, may significantly reduce heart, left anterior descending coronary artery (LADCA) and lung radiation exposure during left breast RT performed with 3d-CRT technique.Results: Several dosimetric parameters were used in the present study to compare the treatment plans generated by FB and mDIBH images of sixty-nine consecutive patients treated between May 2012 and April 2016 at the Istituto del Radio Radiation Oncology Dept. All data derived by Bio-DVH and the heart NTCP calculation showed that ABC led to significant sparing of organs at risk compared with FB, expecially for the heart and LADCA. We also showed that the mDIBH technique significantly reduced left lung dose: in fact, through inflation, only low density lung tissue remains within the tangential field, thus avoiding its deterioration.Conclusions: Use of mDIBH gives a real advantage on breast cancer RT by reducing the radiation to the organs at risk (OARs) and consequently, the risk of cardiac and pulmonary late side effects.

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