Image-guided Volumetric Modulated Arc Therapy for Breast Cancer: a Feasibility Study and Plan Comparison with Three-dimensional Conformal and Intensity-modulated Radiotherapy

Overview

Journal Br J Radiol

Publisher Oxford University Press

Specialty Radiology

Date 2013 Oct 30

PMID 24167182

Citations 22

Authors

H Badakhshi

D Kaul

J Nadobny

B Wille

J Sehouli

V Budach

Affiliations

Soon will be listed here.

Abstract

Objective: To test the feasibility of volumetric modulated arc therapy (VMAT) in breast cancer and to compare it with three-dimensional conformal radiotherapy (3D-CRT) as conventional tangential field radiotheraphy (conTFRT).

Methods: 12 patients (Stage I, 8: 6 left breast cancer and 2 right breast cancer; Stage II, 4: 2 on each side). Three plans were calculated for each case after breast-conserving surgery. Breast was treated with 50 Gy in four patients with supraclavicular lymph node inclusion, and in eight patients without the node inclusion. Multiple indices and dose parameters were measured.

Results: V95% was not achieved by any modality. Heterogeneity index: 0.16 (VMAT), 0.13 [intensity-modulated radiotherapy (IMRT)] and 0.14 (conTFRT). Conformity index: 1.06 (VMAT), 1.15 (IMRT) and 1.69 (conTFRT). For both indices, IMRT was more effective than VMAT (p=0.009, p=0.002). Dmean and V20 for ipsilateral lung were lower for IMRT than VMAT (p=0.0001, p=0.003). Dmean, V2 and V5 of contralateral lung were lower for IMRT than VMAT (p>0.0001, p=0.005). Mean dose and V5 to the heart were lower for IMRT than for VMAT (p=0.015, p=0.002).

Conclusion: The hypothesis of equivalence of VMAT to IMRT was not confirmed for planning target volume parameter or dose distribution to organs at risk. VMAT was inferior to IMRT and 3D-CRT with regard to dose distribution to organs at risk, especially at the low dose level.

Advances In Knowledge: New technology VMAT is not superior to IMRT or conventional radiotherapy in breast cancer in any aspect.

Citing Articles

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Boccardi M, Cilla S, Fanelli M, Romano C, Bonome P, Ferro M Breast Cancer (Dove Med Press). 2024; 16:611-619.

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Planning System-dependent Recommendations of Intensity-modulated Technique for Breast Radiotherapy: A Literature Review-based Adaptation and Institutional Dosimetric Experience from a Large-volume Tertiary Cancer Care Hospital.

Sarkar B, Pradhan A J Med Phys. 2023; 48(3):221-229.

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Automated hybrid volumetric modulated arc therapy (HVMAT) for whole-breast irradiation with simultaneous integrated boost to lumpectomy area : A treatment planning study.

Cilla S, Romano C, Macchia G, Boccardi M, De Vivo L, Morabito V Strahlenther Onkol. 2021; 198(3):254-267.

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Macchia G, Pezzulla D, Cilla S, Boccardi M, Deodato F Adv Radiat Oncol. 2021; 6(6):100777.

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New fractionations in breast cancer: a dosimetric study of 3D-CRT versus VMAT.

Piras A, Menna S, DAviero A, Marazzi F, Mazzini A, Cusumano D J Med Radiat Sci. 2021; 69(2):227-235.

PMID: 34551211 PMC: 9163458. DOI: 10.1002/jmrs.530.

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