Dosimetric and radiobiological comparison of simultaneous integrated boost radiotherapy for early stage right side breast cancer between three techniques: IMRT, hybrid IMRT and hybrid VMAT

Abstract

Purpose This study aimed at evaluating the clinical impact of full intensity-modulated radiotherapy (IMRT), hybrid IMRT (H-IMRT) and hybrid volumetric-modulated arc therapy (H-VMAT) for early-stage breast cancer with simultaneous integrated boost (SIB), in terms of plan quality and second cancer risk (SCR). Methods Three different plans were designed in full IMRT, hybrid IMRT, and hybrid VMAT for each of twenty patients with early-stage breast cancer. Target quality, organs at risk (OARs) sparing, and SCR were compared among the three plans for each case. Results In compared with H-IMRT, IMRT plans showed deterioration in terms of D2% of SIB, V10 of ipsilateral lung, and excess absolute risk (EAR) to contralateral lung (C-Lung) and esophagus. D2% and the homogeneity index (HI) of SIB, V5 of ipsilateral lung (I-Lung), the Dmean of the esophagus, the EAR to C-Lung and the esophagus with hybrid VMAT dramatically increased by 0.63%, 10%, 17.99%, 149.27%, 230.41%, and 135.29%, respectively (p = 0.024; 0.025; 0.046; 0.011; 0.000; 0.014). Dmean of the heart, the EAR to contralateral breast (C-Breast) and C-Lung by full IMRT was significantly decreased in comparison to the H-VMAT (4.67%, p = 0.033, 26.76%, p = 0.018; 48.05%, p = 0.036). Conclusion The results confirmed that H-IMRT could achieve better target quality and OARs sparing than IMRT and H-VMAT for SIB radiotherapy of early-stage right breast cancer. H-IMRT was the best treatment option, while H-VMAT performed the worst among the three plans in terms of SCR to peripheral OARs.

Dosimetric and radiobiological comparation of 3DCRT, IMRT and VMAT techniques for postmastectomy radiotherapy in left breast cancer patients with positive lymph nodes

“…Previous studies primarily focused on the SCR in early breast cancer patients treated with whole breast irradiation. [14][15][16][17] Our study expands this focus to include patients with locally advanced disease receiving lymph node irradiation and employing the latest intensity-modulated techniques. We used EAR to quantify the risk of radiation-induced solid cancers in various areas: the contralateral breast, contralateral lung, ipsilateral lung, esophagus, and thyroid.…”

“…This study investigated the EAR per 10,000 persons-years at 70 years following exposure at 30 years for ipsilateral and contralateral lungs, contralateral breast, esophagus, and thyroid. The biological parameters for these calculations were sourced from several studies, 17,22,[28][29][30] as detailed in Table 2.…”

“…[10][11][12][13] Notably, even low-dose radiation, though not su cient to cause symptomatic organ toxicities, may increase secondary cancer risks (SCR) over the long term. [14][15][16][17] As the number of long-term survivors increases, there is growing concern about the quality of life post-RT, underscoring the need to predict dose-dependent risks of organ toxicities and radiation-induced SCRs. 18 This study aimed to compare dosimetric outcomes, organ toxicity, and SCR among three PMRT techniques (3DCRT, IMRT, and VMAT) for left breast cancer patients with positive lymph nodes.…”

Dosimetric Evaluation Study of 10-MV FFF Used in SBRT for Lung Tumours

“…This outcome was anticipated due to the utilization of non-coplanar (3DCRT) and non-coplanar IMRT, as they attenuate beam overlap from the targeted tumour region. This contrasted with the coplanar VMAT techniques [13,17].…”

“…The collimator leaves move continuously during the delivery of the radiation to modulate the intensity of the beam and shape it to conform to the shape of the tumour. This allows for precise dose delivery to the tumour while sparing surrounding healthy tissue [13,14].…”