Comparison of dose distributions and organs at risk (OAR) doses in conventional tangential technique (CTT) and IMRT plans with different numbers of beam in left-sided breast cancer

Ayata, H.; Güden, Metin; Ceylan, Cemile; Kucuk, N.; Engin, K.

doi:10.1016/j.rpor.2011.02.001

Cited by 26 publications

(27 citation statements)

References 28 publications

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“…The plans were evaluated according to dose-volume histogram (DVH) analysis, and plan quality was assessed by calculating the mean dose to the contralateral breast, ipsilateral lung, double lungs and heart, and the maximum dose to the spinal cord. The CI and HI were calculated according to the Radiation Therapy Oncology Group definition (24,25) as follows: CI = V RI / TV and HI = I max / RI, with V RI representing the volume (V) of the prescribed dose for the PTV, TV as the total volume of the PTV, I max representing the maximum dose and RI as the prescribed dose of the PTV. These two formulae were therefore changed to CI = V Dprescribed / V PTV and HI = D max / D prescribed .…”

Section: Definition Of Target Volume and Organs At Risk (Oars)mentioning

confidence: 99%

Comparison of plan optimization for single and dual volumetric-modulated arc therapy versus intensity-modulated radiation therapy during post-mastectomy regional irradiation

2016

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Abstract. The aim of the present study was to investigate volumetric-modulated arc therapy (VMAT) with single arc (1ARC) and dual arc (2ARC), and intensity-modulated radiation therapy (IMRT), and to evaluate the quality and delivery efficiency of post-mastectomy regional irradiation. A total of 24 female patients who required post-mastectomy regional irradiation were enrolled into the current study, and 1ARC, 2ARC and IMRT plans were designed for each individual patient. The quality of these plans was evaluated by calculating the homogeneity index (HI), conformity index (CI) and specific volume dose to the ipsilateral lung, double lungs, contralateral breast, heart and spinal cord. For the delivery efficiency of these plans, the total treatment time (TTT) and the number of monitor units (MUs) were evaluated. The 1ARC and 2ARC VMAT plans exhibited significantly better HIs and CIs than IMRT. For dose-volume histogram analysis, 1ARC and 2ARC VMAT spared a more specific volume dose to the ipsilateral lung, double lungs, contralateral breast, heart and spinal cord than IMRT (P<0.05). A lower MU per 2.0-Gy fraction was required for 1ARC (539 MU) and 2ARC (608 MU) than for IMRT (1,051 MU). Thus, TTT was correspondingly reduced in 1ARC and 2ARC compared to IMRT (P<0.05). There was no significant dose-volume difference in all the organs at risk (OARs) between the 1ARC and 2ARC plans (P>0.05), and 2ARC VMAT displayed a better HI and CI than 1ARC VMAT (P<0.05). By contrast, 1ARC VMAT was superior to 2ARC VAMT with regard to MU and TTT (P<0.05). The 1ARC and 2ARC VMAT plans demonstrated significantly better dose distribution in a shorter treatment time than IMRT for post-mastectomy regional irradiation, and spared the majority of OARs without compromising target coverage. The results of the present study suggest that 2ARC VMAT may be an alternative to 1ARC in order to obtain a more optimal HI and CI.

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Section: Definition Of Target Volume and Organs At Risk (Oars)mentioning

confidence: 99%

Comparison of plan optimization for single and dual volumetric-modulated arc therapy versus intensity-modulated radiation therapy during post-mastectomy regional irradiation

2016

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“…Whole-breast irradiation is generally performed with two opposed tangential beams to avoid the abovementioned normal organs while simplifying the treatment plan. Tangential beam intensity-modulated radiation therapy (IMRT) may be employed to enhance the dose homogeneity [6][7][8][9]. Compared with other cancer sites, treatment planning for whole-breast irradiation is relatively simple yet contributes to a large proportion of the workload for the medical personnel in radiation oncology departments, and thus is an ideal candidate for automation.…”

Section: Introductionmentioning

confidence: 99%

Automated Hypofractionated IMRT treatment planning for early-stage breast Cancer

Lin

et al. 2020

Radiat Oncol

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Background: Hypofractionated whole-breast irradiation is a standard adjuvant therapy for early-stage breast cancer. This study evaluates the plan quality and efficacy of an in-house-developed automated radiotherapy treatment planning algorithm for hypofractionated whole-breast radiotherapy. Methods: A cohort of 99 node-negative left-sided breast cancer patients completed hypofractionated whole-breast irradiation with six-field IMRT for 42.56 Gy in 16 daily fractions from year 2016 to 2018 at a tertiary center were replanned with an in-house-developed algorithm. The automated plan-generating C#-based program is developed in a Varian ESAPI research mode. The dose-volume histogram (DVH) and other dosimetric parameters of the automated and manual plans were directly compared. Results: The average time for generating an autoplan was 5 to 6 min, while the manual planning time ranged from 1 to 1.5 h. There was only a small difference in both the gantry angles and the collimator angles between the autoplans and the manual plans (ranging from 2.2 to 5.3 degrees). Autoplans and manual plans performed similarly well in hotspot volume and PTV coverage, with the autoplans performing slightly better in the ipsilateral-lungsparing dose parameters but were inferior in contralateral-breast-sparing. The autoplan dosimetric quality did not vary with different breast sizes, but for manual plans, there was worse ipsilateral-lung-sparing (V 4Gy ) in larger or medium-sized breasts than in smaller breasts. Autoplans were generally superior than manual plans in CI (1.24 ± 0.06 vs. 1.30 ± 0.09, p < 0.01) and MU (1010 ± 46 vs. 1205 ± 187, p < 0.01). Conclusions:Our study presents a well-designed standardized fully automated planning algorithm for optimized whole-breast radiotherapy treatment plan generation. A large cohort of 99 patients were re-planned and retrospectively analyzed. The automated plans demonstrated similar or even better dosimetric quality and efficacy in comparison with the manual plans. Our result suggested that the autoplanning algorithm has great clinical applicability potential.

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“…It involves more complex beam arrangements and more beam angles than FIF-IMRT. High-dose regions of ipsilateral lung and heart for tumors of the left breast can be reduced compared with FIF-IMRT [3]. However, MF-IMRT is associated with an increased low-dose area, especially for organs not normally irradiated in conventional tangential radiotherapy, such as the contralateral lung and breast.…”

Section: Introductionmentioning

confidence: 99%

Low-Dose-Area-Constrained Helical TomoTherapy-Based Whole Breast Radiotherapy and Dosimetric Comparison with Tangential Field-in-Field IMRT

Qin

Liu

Yang

et al. 2013

BioMed Research International

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Background and Purpose. To present a novel helical TomoTherapy-based method for whole breast radiotherapy that has better dosimetry and also has acceptable low-dose regions for lungs, heart, and contralateral breast compared with tangential field-in-field IMRT (FIF-IMRT). Material and Methods. Ten patients with left-side breast cancer were planned with low-dose-area-constrained helical TomoTherapy (LDC-HT) and FIF-IMRT. Dosimetry was compared for all techniques. Results. Coverage of the whole breast was adequate with both techniques. Homogeneity index (HI) and conformity index (CI) were better with LDC-HT. LDC-HT showed dosimetry advantages over FIF-IMRT for ipsilateral lung and heart in not only high-dose levels but also in low-dose levels such as V 10 Gy and V 5 Gy. For contralateral lung, both techniques can provide good protection, although the mean dose of LDC-HT is higher than that of FIF-IMRT. Conclusions. With LDC-HT, we obtained adequate target coverage, better HI and CI of target volume, better sparing of organs at risk, and acceptably low-dose areas compared with FIF-IMRT. LDC-HT could be a feasible method in whole breast radiotherapy. Clinical benefits of LDC-HT need further investigation.

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Comparison of dose distributions and organs at risk (OAR) doses in conventional tangential technique (CTT) and IMRT plans with different numbers of beam in left-sided breast cancer

Abstract: IMRT significantly improved conformity and homogeneity index for plans. Heart and lung volumes receiving high doses were decreased, but OAR receiving low doses was increased.

Cited by 26 publications

References 28 publications

Comparison of plan optimization for single and dual volumetric-modulated arc therapy versus intensity-modulated radiation therapy during post-mastectomy regional irradiation

Comparison of plan optimization for single and dual volumetric-modulated arc therapy versus intensity-modulated radiation therapy during post-mastectomy regional irradiation

Automated Hypofractionated IMRT treatment planning for early-stage breast Cancer

Low-Dose-Area-Constrained Helical TomoTherapy-Based Whole Breast Radiotherapy and Dosimetric Comparison with Tangential Field-in-Field IMRT

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