Dosimetric comparison of different intensity-modulated radiotherapy techniques for whole-breast irradiation of right-breast cancer |
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| Affiliation: | 1. Service d’ORL et chirurgie cervico-faciale, CHU de Clermont-Ferrand, Clermont-Ferrand, France;2. Unité de nutrition humaine (UNH), université Clermont Auvergne, INRAE, CNRH Auvergne, Clermont-Ferrand, France;3. Service de biostatistiques, DCRI, CHU de Clermont-Ferrand, Clermont-Ferrand, France;4. Service de radiologie, CHU de Clermont-Ferrand, Clermont-Ferrand, France;5. Service d’oncologie médicale, centre Jean-Perrin, Clermont-Ferrand, France;6. Service de radiothérapie, centre Jean-Perrin, Clermont-Ferrand, France;7. Service de nutrition clinique, CHU de Clermont-Ferrand, Clermont-Ferrand, France;1. Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Center, New Delhi, India;2. Department of biostatistics, Rajiv Gandhi Cancer Institute and Research Center, New Delhi, India;1. Department of Radiation Oncology, University Hospital Center of Lausanne (CHUV), rue du Bugnon 46, 1011 Lausanne, Switzerland;2. Institut national de la santé et de la recherche médicale (Inserm), U1296 Research Unit « Radiations: Defense, Health and Environment », centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France;3. Division of Pulmonology, University Hospital Center of Lausanne (CHUV), rue du Bugnon 46, 1011 Lausanne, Switzerland;4. Department of Radiation Oncology, University Hospital of Genève (HUG), rue Gabrielle-Perret-Gentil, 1205 Genève, Switzerland;5. Department of Medical Oncology, University Hospital Center of Lausanne (CHUV), rue du Bugnon 46, 1011 Lausanne, Switzerland;6. Department of Thoracic Surgery, University Hospital Center of Lausanne (CHUV), rue du Bugnon 46, 1011 Lausanne, Switzerland;7. Lausanne University (UNIL), Lausanne, Switzerland;1. Department of Radiotherapy, CHU UCL Namur, Site Ste Elisabeth, Namur, Belgium;2. Department of Radiotherapy, Cliniques Universitaires Saint-Luc, Brussels, Belgium;3. Department of Medical Oncology, CHU UCL Namur, Site Ste Elisabeth, Namur, Belgium;4. Department of Radiotherapy, Institut Jules-Bordet, Université Libre Bruxelles, Brussels, Belgium;1. Department of Radiation Oncology, Institut Godinot, Reims, France;2. Department of Otolaryngology–Head and Neck Surgery, Hôpital Robert Debré, Reims, France;3. Department of Oncology Care Unit, Hôpital Robert Debré, Reims, France;4. Department of Radiation Oncology, Polyclinique Courlancy, Reims, France |
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| Abstract: | PurposeThis study compared the dosimetric parameters of field-in-field forward intensity-modulated radiotherapy (FIF-IMRT) and fixed-field inversely optimized intensity-modulated radiotherapy (FFIO-IMRT) for the whole-breast irradiation of patients undergoing right-breast lumpectomy.Material and methodsA total of 30 patients with pT1-2N0M0 right-breast invasive ductal carcinoma were enrolled in this study. Two different treatment plans, i.e., FIF-IMRT and FFIO-IMRT, were designed for each patient. The dosimetric parameters of the two treatment plans were compared including ipsilateral lung and heart, conformity index (CI), and the homogeneity index (HI) of the planning target volume (PTV).ResultsFixed-field inversely optimized intensity-modulated radiotherapy was found to significantly improve CI (83.302% vs. 60.146%) and HI (11.837% vs. 19.280%), and significantly reduced V25 (18.038% vs. 19.653%) and V30 (15.790% vs. 18.492%) of the ipsilateral lung. It also significantly increased V5 (69.791% vs. 32.615%) of the ipsilateral lung and V5 (61.579% vs. 3.829%), V10 (14.130% vs. 0.381%), V20 (1.843% vs. 0.051%), and Dmean (5.211 Gy vs. 1.870 Gy) of the heart.ConclusionRegardless of improving the conformity and homogeneity of PTV and reducing the ipsilateral lung irradiation volume at high doses, FFIO-IMRT significantly raised the ipsilateral lung irradiated volume at low doses, as well as the irradiation volume and mean radiation doses to the heart. This limits its use in patients with early-stage right breast cancer. |
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| Keywords: | Breast cancer Whole-breast radiation therapy IMRT Dosimetric parameters Breast lumpectomy Cancer du sein Radiothérapie du sein entier IMRT Paramètres dosimétriques Tumorectomie du sein |
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