Highlights
- •TomoDirect, RapidArc, Elekta VMAT and FinF plans compared for breast irradiation.
- •TomoDirect, RapidArc and Elekta VMAT achieve highest dose coverage.
- •TomoDirect, RapidArc and Elekta VMAT spare the organs in the vicinity of the PTV.
- •FinF has the lowest dose on contralateral organs.
- •FinF has the shortest treatment delivery time.
Abstract
Purpose
The dosimetric differences between four radiation therapy techniques for left sided
whole breast irradiation were evaluated side by side in the same patient population.
Methods
Radiotherapy treatment plans were retrospectively created with Accuray TomoDirect
(TD), Elekta Volumetric Modulated Arc Therapy (E-VMAT), Varian RapidArc (RA) and Field-in-field
(FinF) technique for 20 patients, who had received left breast irradiation during
deep-inspiration breath-hold. Dose characteristics of planning target volume and organs
at risk were compared.
Results
The E-VMAT, TD and RA treatment plans had higher target coverage (V95%) than FinF
plans (97.7–98.3% vs. 96.6%). The low-dose spillage to contralateral breast and lung
was smaller with FinF and TD (mean 0.1 and 0.3 Gy) compared to E-VMAT and RA (mean
0.6 and 0.9 Gy). E-VMAT, RA and TD techniques were more effective than FinF in sparing
left anterior descending artery (mean 4.0, 4.2 and 4.7 Gy vs. 6.1 Gy, respectively).
Conclusions
In whole breast irradiation TD, E-VMAT and RA plans generated in this study achieved
higher dose coverage and sparing of organs from the high dose in the vicinity of the
PTV. The advantage of calculated FinF plans is the lowest dose on contralateral organs.
The choice of the technique used should be weighted by each institution taking into
account the dose characteristics of each technique and its fit with patient anatomy
bearing in mind the increased workload of using modulated techniques and the increased
beam on time.
Keywords
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Article info
Publication history
Accepted:
December 12,
2017
Received in revised form:
November 22,
2017
Received:
June 14,
2017
Identification
Copyright
© 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
