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Dosimetric Comparison and Evaluation of Three Radiotherapy Techniques for Use after Modified Radical Mastectomy for Locally Advanced Left-sided Breast Cancer.

Ma C, Zhang W, Lu J, Wu L, Wu F, Huang B, Lin Y, Li D - Sci Rep (2015)

Bottom Line: P < 0.05 was considered statistically significant.Both 5F-IMRT and 2P-VMAT plans exhibited similar PTV coverage (V95%), hotspot areas (V110%) and conformity (all p > 0.05), and significantly higher PTV coverage compared with 3DCRT-FinF (both p < 0.001).Individually quantifying and minimizing CTV displacement can significantly improve dosage distribution.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, 515031, Guangdong Province, China.

ABSTRACT
This study aimed to compare the post-modified radical mastectomy radiotherapy (PMRMRT) for left-sided breast cancer utilizing 3-dimensional conformal radiotherapy with field-in-field technique (3DCRT-FinF), 5-field intensity-modulated radiation therapy (5F-IMRT) and 2- partial arc volumetric modulated arc therapy (2P-VMAT). We created the 3 different PMRMRT plans for each of the ten consecutive patients. We performed Kruskal-Wallis analysis of variance (ANOVA) followed by the Dunn's-type multiple comparisons to establish a hierarchy in terms of plan quality and dosimetric benefits. P < 0.05 was considered statistically significant. Both 5F-IMRT and 2P-VMAT plans exhibited similar PTV coverage (V95%), hotspot areas (V110%) and conformity (all p > 0.05), and significantly higher PTV coverage compared with 3DCRT-FinF (both p < 0.001). In addition, 5F-IMRT plans provided significantly less heart and left lung radiation exposure than 2P-VMAT (all p < 0.05). The 3DCRT-FinF plans with accurately estimated CTV displacement exhibited enhanced target coverage but worse organs at risk (OARs) sparing compared with those plans with underestimated displacements. Our results indicate that 5F-IMRT has dosimetrical advantages compared with the other two techniques in PMRMRT for left-sided breast cancer given its optimal balance between PTV coverage and OAR sparing (especially heart sparing). Individually quantifying and minimizing CTV displacement can significantly improve dosage distribution.

No MeSH data available.


Related in: MedlinePlus

Transverse, coronal and sagittal dose distribution curves for the 3 techniques in a representative patient.(a, d, g), (b, e, h) and (c, f, i) showed the dosage distribution for 3DCRT-FinF, 5F-IMRT and 2P-VMAT, respectively.
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f1: Transverse, coronal and sagittal dose distribution curves for the 3 techniques in a representative patient.(a, d, g), (b, e, h) and (c, f, i) showed the dosage distribution for 3DCRT-FinF, 5F-IMRT and 2P-VMAT, respectively.

Mentions: The mean volumes, averaged from the 10 patients, for PTV, heart, left lung, right lung, right breast and left humeral head were 813.16 ± 176.78, 486.54 ± 91.45, 982.23 ± 205.19, 1195.87 ± 221.02, 458.99 ± 232.25 and 41.13 ± 7.94 (cm3), respectively. There were significant differences in D2%, D98%, V95%, V110%, HI and CI in PTV among the new 3DCRT-FinF, 5F-IMRT and 2P-VMAT plans (Fig. 1, Fig. 2 and Table 1). For example, the 5F-IMRT (V95% = 99.16 ± 0.33) and 2P-VMAT (V95% = 98.45 ± 0.51) plans provided significantly increased PTV dose coverage compared with the 3DCRT-FinF plans (V95% = 78.23 ± 4.25) (both p < 0.001). Both 5F-IMRT and 2P-VMAT plans exhibited similar PTV dose coverage, hotspot areas (V110%), homogeneity and conformity, with V95% values of 99.16 ± 0.33 and 98.45 ± 0.51, V110% values of 0.22 ± 0.43 and 2.09 ± 3.38, HI values of 0.107 ± 0.013 and 0.124 ± 0.025, and CI values of 0.64 ± 0.07 and 0.68 ± 0.07, respectively (all p > 0.05) (Fig. 1 and Table 1). The averages total MUs were 456.10 ± 20.98, 1021.10 ± 343.10 and 403.60 ± 31.60 MU for the 3DCRT-FinF, 5F-IMRT and 2P-VMAT plans, respectively (Table 1).


Dosimetric Comparison and Evaluation of Three Radiotherapy Techniques for Use after Modified Radical Mastectomy for Locally Advanced Left-sided Breast Cancer.

Ma C, Zhang W, Lu J, Wu L, Wu F, Huang B, Lin Y, Li D - Sci Rep (2015)

Transverse, coronal and sagittal dose distribution curves for the 3 techniques in a representative patient.(a, d, g), (b, e, h) and (c, f, i) showed the dosage distribution for 3DCRT-FinF, 5F-IMRT and 2P-VMAT, respectively.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508617&req=5

f1: Transverse, coronal and sagittal dose distribution curves for the 3 techniques in a representative patient.(a, d, g), (b, e, h) and (c, f, i) showed the dosage distribution for 3DCRT-FinF, 5F-IMRT and 2P-VMAT, respectively.
Mentions: The mean volumes, averaged from the 10 patients, for PTV, heart, left lung, right lung, right breast and left humeral head were 813.16 ± 176.78, 486.54 ± 91.45, 982.23 ± 205.19, 1195.87 ± 221.02, 458.99 ± 232.25 and 41.13 ± 7.94 (cm3), respectively. There were significant differences in D2%, D98%, V95%, V110%, HI and CI in PTV among the new 3DCRT-FinF, 5F-IMRT and 2P-VMAT plans (Fig. 1, Fig. 2 and Table 1). For example, the 5F-IMRT (V95% = 99.16 ± 0.33) and 2P-VMAT (V95% = 98.45 ± 0.51) plans provided significantly increased PTV dose coverage compared with the 3DCRT-FinF plans (V95% = 78.23 ± 4.25) (both p < 0.001). Both 5F-IMRT and 2P-VMAT plans exhibited similar PTV dose coverage, hotspot areas (V110%), homogeneity and conformity, with V95% values of 99.16 ± 0.33 and 98.45 ± 0.51, V110% values of 0.22 ± 0.43 and 2.09 ± 3.38, HI values of 0.107 ± 0.013 and 0.124 ± 0.025, and CI values of 0.64 ± 0.07 and 0.68 ± 0.07, respectively (all p > 0.05) (Fig. 1 and Table 1). The averages total MUs were 456.10 ± 20.98, 1021.10 ± 343.10 and 403.60 ± 31.60 MU for the 3DCRT-FinF, 5F-IMRT and 2P-VMAT plans, respectively (Table 1).

Bottom Line: P < 0.05 was considered statistically significant.Both 5F-IMRT and 2P-VMAT plans exhibited similar PTV coverage (V95%), hotspot areas (V110%) and conformity (all p > 0.05), and significantly higher PTV coverage compared with 3DCRT-FinF (both p < 0.001).Individually quantifying and minimizing CTV displacement can significantly improve dosage distribution.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, 515031, Guangdong Province, China.

ABSTRACT
This study aimed to compare the post-modified radical mastectomy radiotherapy (PMRMRT) for left-sided breast cancer utilizing 3-dimensional conformal radiotherapy with field-in-field technique (3DCRT-FinF), 5-field intensity-modulated radiation therapy (5F-IMRT) and 2- partial arc volumetric modulated arc therapy (2P-VMAT). We created the 3 different PMRMRT plans for each of the ten consecutive patients. We performed Kruskal-Wallis analysis of variance (ANOVA) followed by the Dunn's-type multiple comparisons to establish a hierarchy in terms of plan quality and dosimetric benefits. P < 0.05 was considered statistically significant. Both 5F-IMRT and 2P-VMAT plans exhibited similar PTV coverage (V95%), hotspot areas (V110%) and conformity (all p > 0.05), and significantly higher PTV coverage compared with 3DCRT-FinF (both p < 0.001). In addition, 5F-IMRT plans provided significantly less heart and left lung radiation exposure than 2P-VMAT (all p < 0.05). The 3DCRT-FinF plans with accurately estimated CTV displacement exhibited enhanced target coverage but worse organs at risk (OARs) sparing compared with those plans with underestimated displacements. Our results indicate that 5F-IMRT has dosimetrical advantages compared with the other two techniques in PMRMRT for left-sided breast cancer given its optimal balance between PTV coverage and OAR sparing (especially heart sparing). Individually quantifying and minimizing CTV displacement can significantly improve dosage distribution.

No MeSH data available.


Related in: MedlinePlus