The influence of the use of CT-planning on the irradiated boost volume in breast conserving treatment |
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Authors: | Shafak Al Uwini Ninja Antonini Philip M Poortmans Liesbeth Boersma Coen Hurkmans Jan Willem Leer Jean-Claude Horiot Henk Struikmans Harry Bartelink |
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Institution: | a Department of Radiotherapy, Erasmus Medical Centre, Rotterdam, The Netherlands b Department of Radiotherapy, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands c Department of Radiotherapy, Dr. Bernard Verbeeten Institute, Tilburg, The Netherlands d Department of Radiotherapy, University Hospital Maastricht, MAASTRO Clinic, Maastricht, The Netherlands e Department of Radiotherapy, Catharina Hospital, Eindhoven, The Netherlands f Department of Radiotherapy, University Medical Centre Nijmegen, Nijmegen, The Netherlands g Department of Radiotherapy, Centre George-François Leclerc, Dijon, France h Department of Radiotherapy, Medical Centre Haaglanden, Den Haag, The Netherlands |
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Abstract: | Background and purposeThe purpose of this study was to investigate the effect of CT-based delineation and planning on the irradiated boost volume. For this specific purpose we used the data as derived from 2 prospective phase III randomised trials.Patients and methodsData from 1331 patients (?50 years) were analyzed with a reported boost volume from a simulation-based treatment plan (EORTC boost vs no boost trial, n = 922), and a CT-scan-based treatment plan (Young Boost Trial, n = 409) group. Tumour diameter, irradiation technique (photons vs electrons), lumpectomy size, and age were used as covariates.ResultsMedian V95% in the conventional simulation-based treatment plans was 99 cc (range 9-628) for photons and was 98 cc (13-651) for electrons, whereas in the CT-planned patients, these figures were 178 cc (37-2699) and 150 cc (43-1272), respectively. Multivariable analysis showed an association of the irradiated boost volume with tumour size (p < 0.0067), lumpectomy size (p < 0.0002), and boost technique (p < 0.0004). The use of a CT-scan for volume delineation and treatment planning remained significant (p < 0.0001).ConclusionsThe use of a CT-scan for delineation and treatment planning led to a significant increase of the irradiated boost volume by a factor of 1.5-1.8, compared to conventional simulator-based plans. |
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Keywords: | Breast cancer Radiotherapy Boost volume Breast conserving therapy Boost |
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