Dosimetric comparison of left-sided whole breast irradiation with 3D-CRT, IP-IMRT and hybrid IMRT. 2014

Xiaoxue Xie, and Shuyu Ouyang, and Hui Wang, and Wenjuan Yang, and Hekun Jin, and Bingqiang Hu, and Liangfang Shen
Department of Radiation Oncology, Hunan Provincial Tumor Hospital and Affiliated Tumor Hospital of Xiangya Medical School, Central South University, Changsha, Hunan 410013, P.R. China.

The aim of this study was to compare the dosimetric characteristics of left-sided whole breast irradiation among 3-dimensional conformal radiotherapy (3D-CRT), 4-field inverse-planned intensity-modulated radiotherapy (IP-IMRT) and hybrid IMRT technique (combining 3D-CRT beams and IP-IMRT beams) with respect to target coverage and irradiation of organs at risk. The 3 different planning techniques were analyzed for 8 patients with left-sided breast conserving surgery. Plans were compared on the basis of planning target volume (PTV) dose conformity, homogeneity and the volumes of normal tissues treated based on dose-volume histograms (DVHs). DVHs were calculated for the PTV, heart, and the bilateral lungs, contralateral breast, and soft tissue surrounding the breast PTV (VOB) volume. IP-IMRT and hybrid IMRT techniques comparably improved the PTV dose homogeneity and conformity (CI) significantly, compared to the conventional 3D-CRT technique (P<0.017); the IP-IMRT technique only could additionally benefit patients by decreasing the high-dose (40 Gy) volume for heart and ipsilateral lung compared with the hybrid IMRT technique (P<0.017); the hybrid IMRT plans achieved a further improvement by compromising the increase of low-dose volume (total lung V13, contralateral lung V5, heart V10 and soft tissue surrounding the breast V5) compared with IP-IMRT plans (P<0.017). Hybrid IMRT plans achieved equivalent PTV dose uniformity to IP-IMRT plans and compromised the low-dose volume and requirement of clinic resource between IP-IMRT and 3D-CRT plans, promoting it as a standard practice of left-sided breast irradiation for patients in good-ordered cardiopulmonary health.

UI MeSH Term Description Entries
D008168 Lung Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood. Lungs
D011879 Radiotherapy Dosage The total amount of radiation absorbed by tissues as a result of radiotherapy. Dosage, Radiotherapy,Dosages, Radiotherapy,Radiotherapy Dosages
D011880 Radiotherapy Planning, Computer-Assisted Computer-assisted mathematical calculations of beam angles, intensities of radiation, and duration of irradiation in radiotherapy. Computer-Assisted Radiotherapy Planning,Dosimetry Calculations, Computer-Assisted,Planning, Computer-Assisted Radiotherapy,Calculation, Computer-Assisted Dosimetry,Calculations, Computer-Assisted Dosimetry,Computer Assisted Radiotherapy Planning,Computer-Assisted Dosimetry Calculation,Computer-Assisted Dosimetry Calculations,Dosimetry Calculation, Computer-Assisted,Dosimetry Calculations, Computer Assisted,Planning, Computer Assisted Radiotherapy,Radiotherapy Planning, Computer Assisted
D001940 Breast In humans, one of the paired regions in the anterior portion of the THORAX. The breasts consist of the MAMMARY GLANDS, the SKIN, the MUSCLES, the ADIPOSE TISSUE, and the CONNECTIVE TISSUES. Breasts
D001943 Breast Neoplasms Tumors or cancer of the human BREAST. Breast Cancer,Breast Tumors,Cancer of Breast,Breast Carcinoma,Cancer of the Breast,Human Mammary Carcinoma,Malignant Neoplasm of Breast,Malignant Tumor of Breast,Mammary Cancer,Mammary Carcinoma, Human,Mammary Neoplasm, Human,Mammary Neoplasms, Human,Neoplasms, Breast,Tumors, Breast,Breast Carcinomas,Breast Malignant Neoplasm,Breast Malignant Neoplasms,Breast Malignant Tumor,Breast Malignant Tumors,Breast Neoplasm,Breast Tumor,Cancer, Breast,Cancer, Mammary,Cancers, Mammary,Carcinoma, Breast,Carcinoma, Human Mammary,Carcinomas, Breast,Carcinomas, Human Mammary,Human Mammary Carcinomas,Human Mammary Neoplasm,Human Mammary Neoplasms,Mammary Cancers,Mammary Carcinomas, Human,Neoplasm, Breast,Neoplasm, Human Mammary,Neoplasms, Human Mammary,Tumor, Breast
D005260 Female Females
D006321 Heart The hollow, muscular organ that maintains the circulation of the blood. Hearts
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015412 Mastectomy, Segmental Removal of only enough breast tissue to ensure that the margins of the resected surgical specimen are free of tumor. Breast-Conserving Surgery,Lumpectomy,Partial Mastectomy,Breast Conservation Therapy,Breast Quadrantectomy,Breast-Sparing Surgery,Limited Resection Mastectomy,Local Excision Mastectomy,Segmentectomy,Surgery, Breast-Conserving,Breast Conservation Therapies,Breast Conserving Surgery,Breast Quadrantectomies,Breast Sparing Surgery,Breast-Conserving Surgeries,Breast-Sparing Surgeries,Conservation Therapies, Breast,Conservation Therapy, Breast,Limited Resection Mastectomies,Local Excision Mastectomies,Lumpectomies,Mastectomies, Limited Resection,Mastectomies, Local Excision,Mastectomies, Partial,Mastectomies, Segmental,Mastectomy, Limited Resection,Mastectomy, Local Excision,Mastectomy, Partial,Partial Mastectomies,Quadrantectomies, Breast,Quadrantectomy, Breast,Segmental Mastectomies,Segmental Mastectomy,Segmentectomies,Surgeries, Breast-Conserving,Surgeries, Breast-Sparing,Surgery, Breast Conserving,Surgery, Breast-Sparing
D050397 Radiotherapy, Intensity-Modulated CONFORMAL RADIOTHERAPY that combines several intensity-modulated beams to provide improved dose homogeneity and highly conformal dose distributions. Helical Tomotherapy,Intensity-Modulated Arc Therapy,Volumetric-Modulated Arc Therapy,Arc Therapies, Intensity-Modulated,Arc Therapies, Volumetric-Modulated,Arc Therapy, Intensity-Modulated,Arc Therapy, Volumetric-Modulated,Helical Tomotherapies,Intensity Modulated Arc Therapy,Intensity-Modulated Arc Therapies,Intensity-Modulated Radiotherapies,Intensity-Modulated Radiotherapy,Radiotherapies, Intensity-Modulated,Radiotherapy, Intensity Modulated,Therapies, Intensity-Modulated Arc,Therapies, Volumetric-Modulated Arc,Therapy, Intensity-Modulated Arc,Therapy, Volumetric-Modulated Arc,Tomotherapies, Helical,Tomotherapy, Helical,Volumetric Modulated Arc Therapy,Volumetric-Modulated Arc Therapies

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