A novel technique for treating deep seated breast cavity boosts

Master Breast Radiation Planning: Simple Guide for Radiation Oncology Residents

This article focuses on various aspects of breast radiation treatment planning, from simulation to field design. It covers the most common techniques including tangents, mono isocentric, dual isocentric, electron-photon match, and VMAT. This can serve as a guide for radiation oncology residents and medical students to advance their understanding of key aspects of breast radiation treatment and planning processes.

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

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 D_2% of SIB, V₁₀ of ipsilateral lung, and excess absolute risk (EAR) to contralateral lung (C-Lung) and esophagus. D_2% and the homogeneity index (HI) of SIB, V5 of ipsilateral lung (I-Lung), the D_mean 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). D_mean 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.