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Title
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Volumetric modulated arc therapy and breath-hold in image-guided locoregional left-sided breast irradiation
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Author
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Abstract
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| Purpose: To investigate the effects of using volumetric modulated arc therapy (VMAT) and/or voluntary moderate deep inspiration breath-hold (vmDIBH) in the radiation therapy (RT) of left-sided breast cancer including the regional lymph nodes. Materials and methods: For 13 patients, four treatment combinations were compared; 3D-conformal RT (i.e., forward IMRT) in free-breathing 3D-CRT(FB), 3D-CRT(vmDIBH), 2 partial arcs VMAT(FB), and VMAT(vmDIBH). Prescribed dose was 42.56 Gy in 16 fractions. For 10 additional patients, 3D-CRT and VMAT in vmDIBH only were also compared. Results: Dose conformity, PTV coverage, ipsilateral and total lung doses were significantly better for VMAT plans compared to 3D-CRT. Mean heart dose (D-mean,D-heart) reduction in 3D-CRT(vmDIBH) was between 0.9 and 8.6 Gy, depending on initial D-mean,D-heart (in 3D-CRT(FB) plans). VMAT(vmDIBH) reduced the D-mean,D-heart further when D-mean,D-heart was still >3.2 Gy in 3D-CRT(vmDIBH). Mean contralateral breast dose was higher for VMAT plans (2.7 Gy) compared to 3DCRT plans (0.7 Gy). Conclusions: VMAT and 3D-CRT(vmDIBH) significantly reduced heart dose for patients treated with locoregional RT of left-sided breast cancer. When D-mean,D-heart exceeded 3.2 Gy in 3D-CRT(vmDIBH) plans, VMAT(vmDIBH) resulted in a cumulative heart dose reduction. VMAT also provided better target coverage and reduced ipsilateral lung dose, at the expense of a small increase in the dose to the contralateral breast. (C) 2014 Elsevier Ireland Ltd. All rights reserved. |
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Language
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English
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Source (journal)
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Radiotherapy and oncology. - Amsterdam
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Publication
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Amsterdam
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2014
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ISSN
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0167-8140
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DOI
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10.1016/J.RADONC.2014.04.004
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Volume/pages
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112
:1
(2014)
, p. 17-22
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ISI
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000343686000003
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Pubmed ID
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24825176
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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