Purpose:
Dosimetric comparison between volumetric-modulated arc therapy (VMAT) and helical tomotherapy (HT) in the treatment of bilateral breast cancer (BBC).
Materials and methods:
Ten patients treated on HT were selected retrospectively. Dose prescription was 50 Gy in 25 fractions to breast/chest wall and supraclavicular fossa (SCF) while tumour bed was simultaneously boosted to 61 Gy in 25 fractions. VMAT plans were made with four mono-isocentric partial arcs. The monitoring unit (MU) and treatment time were used to quantify the treatment efficiency. Target volumes were compared for homogeneity index (HI), conformity index (CI) while organs at risk (OARs) were compared for relevant dose volumes and integral doses (IDs).
Result:
For targets, no significant difference is observed between VMAT and HT in CI but VMAT could give better HI. The mean lung dose, V20 and V5 is 10·6 Gy versus 8·4 Gy (p-value 0·03), 12% versus 11·5% (p-value 0·5) and 78·1% versus 43·4% (p-value 0·005), respectively. The mean heart dose, V30 and V5 is 4·9 Gy versus 4·7 Gy (p-value 0·88), 0·5% versus 1·5% (p-value 0·18) and 26·2% versus 22·8% (p-value 0·4). Integral dose (ID) for the whole body and heart are comparable: 289 Gy kg versus 299 Gy kg (p-value 0·24) and 2·9 Gy kg versus 2·8 Gy kg (p-value 0·80). ID for lungs was significantly higher with VMAT: 7·9 Gy kg versus 6·3 Gy kg (p-value 0·03). There is a 53% reduction in treatment time and 78% in MU with VMAT against HT.
Conclusion:
VMAT can generate clinically acceptable plans comparable to HT for BBC. HT shows better control over low dose spillage in lungs compared to VMAT thereby increasing ID to lungs. VMAT shows better homogeneity and efficient treatment delivery than HT.
Introduction:
COVID-19 illness caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) virus has been declared a pandemic by the World Health Organization in March 2020. It had an overwhelming effect on health-care delivery in India. We report the 5 months, April–September 2020, experience in our radiotherapy (RT) department.
Methods:
Since April–September 2020, we registered 184 cancer patients with various site diseases for RT/chemoradiation treatment for curative/palliative therapy. Preregistration and weekly once during treatment period all underwent throat/nasopharynx swab testing with reverse transcription polymerase chain reaction. Dedicated infection prophylaxis was carried for patients and staff.
Results:
Of the 184 patients, 10.9% (20/184) swab results were positive for SARS-CoV-2. With appropriate COVID-19 care and quarantine, 18 patients completed the planned RT. Two died with COVID-19 infection illness and progressive locoregional cancer. We observed no excess acute RT/chemoradiation effects in this group due to infection.
Conclusions:
Our 5-month experience in this COVID-19 pandemic period reveals that RT treatment, COVID-19 care, and quarantine can be done with dedicated infection protective measures.
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