Dosimetric comparison of left-sided whole-breast irradiation with 3DCRT, forward-planned IMRT, inverse-planned IMRT, helical tomotherapy, and volumetric arc therapy

Haciislamoglu, Emel; Çolak, Fatma; Canyılmaz, Emine; Dırıcan, Bahar; Gurdalli, S.; Yilmaz, Ahmet Hakan; Yöney, Adnan; Bahat, Zümrüt

doi:10.1016/j.ejmp.2015.02.005

Cited by 54 publications

(49 citation statements)

References 33 publications

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“…For breast cancer patients, reducing the dose to OARs from radiotherapy treatments is important as the 10‐year survival probability for diagnosed stage I and II patients treated with radiation after breast‐conserving therapy is higher than 60% . Several studies have reported dose to the OARs from the different modalities available for radiation delivery including three dimensional conformal therapy (3D‐CRT), tomotherapy, static‐field intensity‐modulated radiation therapy (IMRT) and volumetric arc therapy (VMAT) …”

Section: Introductionmentioning

confidence: 99%

Dosimetric study of the plan quality and dose to organs at risk on tangential breast treatments using the Halcyon linac

Flores‐Martinez

Kim

Yashar

et al. 2019

J Applied Clin Med Phys

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Purpose To investigate the plan quality and doses to the heart, contralateral breast (CB), ipsilateral lung (IL), and contralateral lung (CL) in tangential breast treatments using the Halcyon linac with megavoltage setup fields. Methods Radiotherapy treatment plans with tangential beams from 25 breast cancer patients previously treated on a C‐arm linac were replanned for Halcyon. Thirteen corresponded to right‐sided breasts and 12 to left‐sided breasts, all with a dose prescription of 50 Gy in 25 fractions. Plans were created with the following setup imaging techniques: low‐dose (LD) MVCBCT, high‐quality (HQ) MVCBCT, LD‐MV and HQ‐MV pairs and the imaging dose was included in the plans. Plan quality metric values for the lumpectomy cavity, whole‐breast and doses to the organs at risk (OARs) were measured and compared with those from the original plans. Results No significant differences in plan quality were observed between the original and Halcyon plans. An increase in the mean dose (Mean) for all the organs was observed for the Halcyon plans. For right‐sided plans, the accumulated Mean over the 25 fractions in the C‐arm plans was 0.4 ± 0.3, 0.2 ± 0.2, 5.4 ± 1.3, and 0.1 ± 0.1 Gy for the heart, CB, IL, and CL, respectively, while values in the MVCBCT‐LD Halcyon plans were 1.2 ± 0.2, 0.6 ± 0.1, 6.5 ± 1.4, and 0.4 ± 0.1 Gy, respectively. For left‐sided treatments, Mean in the original plans was 0.9 ± 0.2, 0.1 ± 0.0, 4.2 ± 1.2, and 0.0 ± 0.0 Gy, while for the MVCBCT‐LD Halcyon plans values were 1.9 ± 0.2, 0.6 ± 0.2, 5.1 ± 1.2, and 0.5 ± 0.2 Gy, respectively. Conclusions Plan quality for breast treatments using Halcyon is similar to the quality for a 6 MV, C‐arm plan. For treatments using megavoltage setup fields, the dose contribution to OARs from the imaging fields can be equal or higher than the dose from treatment fields.

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Section: Introductionmentioning

confidence: 99%

Dosimetric study of the plan quality and dose to organs at risk on tangential breast treatments using the Halcyon linac

Flores‐Martinez

Kim

Yashar

et al. 2019

J Applied Clin Med Phys

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“…With excellent high‐dose conformity, Haciislamoglu et al3 among others argue the merits of helical delivery in WBRT. Franco et al11 state the obvious drawback of helical techniques: larger integral dose.…”

Section: Discussionmentioning

confidence: 99%

“…The TomoTherapy HD platform allows for helical delivery over a rotational interval of 7°, up to a total of 51 projections for each gantry revolution. With excellent high-dose conformity, Haciislamoglu et al 3 among others argue the merits of helical delivery in WBRT. Franco et al 11 state the obvious drawback of helical techniques: larger integral dose.…”

Section: Static Beam Angle Versus Helical Techniquesmentioning

confidence: 99%

“…1,2 Recent technical advances have resulted in a transition away from conventional tangential approaches and towards more complex methodologies, such as inverse planned intensity modulated radiation therapy (IP-IMRT) and helical techniques. 3,4 These advances have sought to enhance normal tissue sparing and improve target homogeneity, as well as provide a platform for a simultaneous integrated boost to the tumour bed. 5,6 TomoTherapy (Accuray, Sunnyvale, CA) has recently introduced topotherapy, 7 a static form of tomotherapy, to increase the versatility of its helical system.…”

Section: Introductionmentioning

confidence: 99%

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Static beam tomotherapy as an optimisation method in whole‐breast radiation therapy (WBRT)

Squires

Byrne³

et al. 2017

J of Medical Radiation Sci

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IntroductionTomoTherapy (Accuray, Sunnyvale, CA) has recently introduced a static form of tomotherapy: TomoDirect™ (TD). This study aimed to evaluate TD against a contemporary intensity modulated radiation therapy (IMRT) alternative through comparison of target and organ at risk (OAR) doses in breast cancer cases. A secondary objective was to evaluate planning efficiency by measuring optimisation times.MethodsTreatment plans of 27 whole‐breast radiation therapy (WBRT) patients optimised with a tangential hybrid IMRT technique were replanned using TD. Parameters included a dynamic field width of 2.5 cm, a pitch of 0.251 and a modulation factor of 2.000; 50 Gy in 25 fractions was prescribed and planning time recorded. The planning metrics used in analysis were ICRU based, with the mean PTV minimum (D99) used as the point of comparison.ResultsBoth modalities met ICRU50 target heterogeneity objectives (TD D99 = 48.0 Gy vs. IMRT = 48.1 Gy, P = 0.26; TD D1 = 53.5 Gy vs. IMRT = 53.0 Gy, P = 0.02; Homogeneity index TD = 0.11 vs. IMRT = 0.10, P = 0.03), with TD plans generating higher median doses (TD D50 = 51.1 Gy vs. IMRT = 50.9 Gy, P = 0.03). No significant difference was found in prescription dose coverage (TD V50 = 85.5% vs. IMRT = 82.0%, P = 0.09). TD plans produced a statistically significant reduction in V5 ipsilateral lung doses (TD V5 = 23.2% vs. IMRT = 27.2%, P = 0.04), while other queried OARs remained comparable (TD ipsilateral lung V20 = 13.2% vs. IMRT = 14.6%, P = 0.30; TD heart V5 = 2.7% vs. IMRT = 2.8%, P = 0.47; TD heart V10 = 1.7% vs. IMRT = 1.8%, P = 0.44). TD reduced planning time considerably (TD = 9.8 m vs. IMRT = 27.6 m, P < 0.01), saving an average planning time of 17.8 min per patient.ConclusionsTD represents a suitable WBRT treatment approach both in terms of plan quality metrics and planning efficiency.

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“…However, two separate comparative dosimetric studies – which generated two plans, 3D CRT and IP IMRT, for each computed tomography data set – demonstrated that IP IMRT resulted in superior dose conformity with a larger volume receiving low dose 29,30. Hence, it could be expected that IP IMRT can reduce toxicities and improve overall cosmesis.…”

Section: Types Of Breast Imrt Techniquesmentioning

confidence: 99%

Intensity-modulated radiation therapy for early-stage breast cancer: is it ready for prime time?

Chan¹,

Tan²,

Tang³

2017

BCTT

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Whole breast external beam radiotherapy (WBEBRT) is commonly used as an essential arm in the treatment management of women with early-stage breast cancer. Dosimetry planning for conventional WBEBRT typically involves a pair of tangential fields. Advancement in radiation technology and techniques has the potential to improve treatment outcomes with clinically meaningful long-term benefits. However, this advancement must be balanced with safety and improved efficacy. Intensity-modulated radiation therapy (IMRT) is an advanced technique that shows promise in improving the planning process and radiation delivery. Early data on utilizing IMRT for WBEBRT demonstrate more homogenous dose distribution with reduction in organs at risk doses. This translates to toxicities reduction. The two common descriptors for IMRT are forward-planning “fields in field” and inverse planning. Unlike IMRT for other organs, the aim of IMRT for breast planning is to achieve dose homogeneity and not organ conformality. The aim of this paper was to evaluate whether IMRT is ready for prime time based on these three points: 1) workload impact, 2) the clinical impact on the patient’s quality of life, and 3) the appropriateness and applicability to clinical practice.

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Dosimetric comparison of left-sided whole-breast irradiation with 3DCRT, forward-planned IMRT, inverse-planned IMRT, helical tomotherapy, and volumetric arc therapy

Cited by 54 publications

References 33 publications

Dosimetric study of the plan quality and dose to organs at risk on tangential breast treatments using the Halcyon linac

Dosimetric study of the plan quality and dose to organs at risk on tangential breast treatments using the Halcyon linac

Static beam tomotherapy as an optimisation method in whole‐breast radiation therapy (WBRT)

Intensity-modulated radiation therapy for early-stage breast cancer: is it ready for prime time?

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