Organ at risk dose calculation for left sided breast cancer treatments using intraoperative electron radiotherapy: A Monte Carlo-based feasibility study

Dosimetric comparison between different tangential field arrangements during left-sided breast cancer radiotherapy

This study aimed to evaluate variations in dose distribution within the target volume and dose received by the organs at risk (OARs) for different tangential field arrangements during three-dimensional (3D) conformal treatment planning for left-sided breast cancer. Computed tomography (CT) images of 25 breast cancer patients were included, and three different mono-isocentric half-block (MIHB) treatment plans-parallel central axis technique (PCAXT), posterior border parallel technique (PBPT), and parallel quadrant technique (PQUDT)-were considered for each patient. The dosimetric and geometric parameters related to each followed plan were then extracted for the planning target volume (PTV) and the OARs, and compared. The results showed no significant differences among the extracted dosimetric and geometric parameters of the OARs for the different plans, while the D_max, V_95%, homogeneity index (HI), and conformity index (CI) values related to the PTV were significantly different (P < 0.05). The lowest D_max and V_95% values inside the PTV were related to the PCAXT plan. The best HI was achieved with the PBPT plan, whereas the best CI was observed for the PCAXT plan. The best correlation between the geometric and dosimetric parameters of the OARs was between V_5Gy-central lung distance for the ipsilateral lung and the V_5Gy-maximum heart distance for the heart in all plans. These results demonstrate that variations in the tangential field arrangement at the posterior border for optimal coverage of the PTV may not considerably affect the dose received by the OARs.