Comparison of treatment planning techniques in treatment of carcinoma of left breast: Second cancer perspective

Sakthivel, Vasanthan; Mani, Ganesh Kadirampatti; Mani, S.; Boopathy, Raghavendiran

doi:10.1016/j.radphyschem.2016.11.009

Cited by 3 publications

(5 citation statements)

References 34 publications

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“…Although inverse planning provides a superior dose coverage to tumor and spare OARs, low-dose spillage in normal tissue which increases the risk of secondary malignancies is also a concern. [ 7 19 20 ]…”

Section: Discussionmentioning

confidence: 99%

Dosimetric comparison of different planning techniques in left-sided whole-breast irradiation: A planning study

et al. 2020

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Purpose: This planning study compared the various dosimetric parameters of different types of intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) techniques for left-sided breast cancer radiotherapy. Materials and Methods: Treatment of 22 left-sided breast cases was planned using two IMRT and VMAT techniques for the prescription of 40 Gy in 15 fractions. For tangential IMRT (Tan_IMRT), five beams were placed as conventional tangential beams. For equally spaced IMRT (Equi_IMRT), six beams were placed equidistantly at 40° interval from 300° to 140°. For tangential VMAT (Tan_VMAT), two arcs were used with the avoidance sector in such a way that the beam covered like tangential fields. For full-arc VMAT (Full_VMAT), similar arcs as Tan_VMAT were used, without avoidance sector. All treatment plans were generated using Eclipse planning system for TrueBeam STx linear accelerator. For planning target volume (PTV), dose parameters including D 95% , D 99% , V 105% homogeneity index (HI), and conformity index (CI) were analyzed. Different dose parameters for the left lung, heart, left anterior descending artery (LAD), right lung, and right breast were also analyzed. In addition, low-dose spillage in the normal tissues and the number of monitor units (MUs) required for the treatment were compared. Results: IMRT technique exhibited superior D 95% and D 99% for PTV compared with VMAT techniques. VMAT plans provided more V 105% (6%) compared with that of IMRT plans (approximately 1%). HI was better in IMRT plans (Tan_IMRT, 0.085 ± 0.015; Equi_IMRT, 0.094 ± 0.011) than in VMAT plans. CI was better in VMAT plans. The mean lung dose (7.7 Gy ± 1.788 Gy) and V 5Gy (34.99% ± 6.799%) were better achieved in Tan_IMRT plan than other plans. Right lung, heart, and right breast sparing were better achieved in Tan_IMRT plan. Moreover, low-dose spillage was very less in the Tan_IMRT compared with all other techniques. Conclusion: Dosimetric comparison in this study showed that tangential IMRT technique is superior in terms of target coverage, sparing of lung, heart, and right breast, and low-dose spillage control in the left-sided breast-only radiotherapy.

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Section: Discussionmentioning

confidence: 99%

Dosimetric comparison of different planning techniques in left-sided whole-breast irradiation: A planning study

et al. 2020

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“…Optimization and conformation to treated volume consequence reduce in relative OED in all three relationships dose-response. Volumetric arc therapy and intensity modulated radiation therapy plan decreases volume receive high dose close to normal organs by increasing the numbers of field to attain more conformed dose while increasing spare of the low dose across a larger volume while a resulting a high doses to skin [12].…”

Section: Organ Equivalent Dosementioning

confidence: 99%

“…Where doses for organs at a distant from the treated volume in volumetric modulated arc therapy increases the risk of second cancer to these organs. Conventional plans compared to new complicated plans are reported to increase second cancer risk organs at risk like in heart and left lung [12].…”

Section: Organ Equivalent Dosementioning

confidence: 99%

“…Radiotherapy patients sometimes have increasing risk to develop second cancer due to some factors as genetic, environment and their culture which is more dominant than risk from radiation [15] from dose-response curve we can't know which model is reasonable for carcinogenesis but Plateau model may be suitable to evaluate risk of second cancer [12].…”

Section: Organ Equivalent Dosementioning

confidence: 99%

“…The risk rises by low doses of radiation reaching a highest rate and then reduces with the rising dose. The best way to minimize the risk of second tumors is to decrease radiation dose to sites where the dose is already low [11] [12].…”

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confidence: 99%

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Influence of Distinct Radiotherapy Techniques to Induce Second Cancer Risks in Left Breast Cancer

Elgendy¹,

Attia²,

Attalla³

et al. 2018

IJMPCERO

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Influence of distinct radiotherapy techniques to induce second cancer risks in left breast cancer. Material and methods: Ten female patients with intact left breast cancer. Two treatment plans for each patient: 1) two tangential beams 3D-Conformal radiotherapy, 2) intensity-modulated radiotherapy (IMRT) plan. Estimation of second cancer risk from Organ equivalent dose models (OEDs) in three dose-response model for organs at risk in left breast cases. Results: The P-value for OED models in 3D-IMRT for left lung, both lung, heart, right lung, right breast, thyroid, liver and spinal cord in linear dose model was 0.016, 0.005, 0.019, 3.95E−06, 5.79E−07, 0.003, 1.78E−10 and 0.000206475 respectively, for linear exponential dose model 0.0577, 0.024, 0.031, 3.40E−06, 3.28E−07, 0.003, 2.01E−10 and 0.000120072 respectively and in plateau dose model 0.088, 0.042, 0.039, 3.18E−06, 2.53E−07, 0.003, 2.27E−10 and 9.00535E−05 respectively. Conclusion: organ equivalent dose models for organs at risk increasing in IMRT than tangential beams.

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Evaluation of the clinical application of Auto-Planning module for IMRT plans of left breast cancer

Liu

Dong

Yang

et al. 2020

Radiation Physics and Chemistry

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Comparison of treatment planning techniques in treatment of carcinoma of left breast: Second cancer perspective

Cited by 3 publications

References 34 publications

Dosimetric comparison of different planning techniques in left-sided whole-breast irradiation: A planning study

Dosimetric comparison of different planning techniques in left-sided whole-breast irradiation: A planning study

Influence of Distinct Radiotherapy Techniques to Induce Second Cancer Risks in Left Breast Cancer

Evaluation of the clinical application of Auto-Planning module for IMRT plans of left breast cancer

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