Abstract
Objective: Comparative study of dose parameters of Volumetric modulated arc therapy (VMAT) and three-dimension radiotherapy (3D-CRT) in patients after left breast surgery with radiation therapy with regional lymph nodes.
Materials and Methods: Twenty-four plans of 12 left-breast cancer patients were treated with VMAT with 4 partial arc and 3D-CRT plans were added to compare each other, from 1/2018 to 3/2019 at the Vinmec TimesCity International Hospital.
Results: The average coverage dose to the treatment volume (PTV) of VMAT plans is better than the 3D-CRT plan (99.10 ± 0.17% compared to 98.7 ± 0.34%; p = 0.01). Conformity index (CI), homogeneity index (HI) for VMAT plans also better results CI: 0.99 vs. 0.98; p = 0.26 and HI: 0.096 compared to 0.119; p = 0.02). Organs at risk, at low doses V5Gy, V10Gy VMAT plans do not avoid good doses by 3D-CRT plans: V5Gy for left lung (78.8 ± 4.6% compared to 55.37 ± 4.38%) and heart (77.15 ± 9.52% compared to 19.15 ± 7.93%) (p 0.05), V30Gy (9.25 ± 5.56% compared to 2.13 ± 1.89%) and V40 Gy (7.54 ± 5.03% compared with 0.2 ± 0.25%). Dose to coronary arteries also decreased significantly for VMAT plans compared to 3D-CRT: V20Gy (0.8 ± 1.01% compared to 27.29 ± 15.19%) V30Gy (0.00% compared to 23.09 ± 10.73%).
Conclusion: VMAT is dosimetrically superior to the 3D-CRT for left‑sided breast cancer patients with regional nodes by dose coverage to PTV and good ability to avoid heart and lung and coronary arteries than.
References
Available from: http://www.globocan.iarc.fr/ Pages/fact_sheets_ population.aspx [2015].
Overgaard M, Nielsen HM. Is the benefit ofpostmastectomy irradiation limited to patients with four or morepositive nodes, as recommended in international consensus reports? A subgroup analysis of the DBCG 82 b&c randomized trials. RadiotherOncol 2007;82:24753.
McGale P,Taylor C, Correa C,et al. Effect of radiotherapy aftermastectomy and axillary surgery on 10year recurrence and 20yearbreast cancer mortality: Metaanalysis of individual patient data for8135 women in 22 randomised trials. Lancet 2014;383:212735.
Zablotska LB, Neugut AI. Lung carcinoma after radiation therapy inwomen treated with lumpectomy or mastectomy for primary breastcarcinoma. Cancer 2003;97:140411.
Darby SC, Ewertz M, McGale P, et al. Risk of ischemic heart disease in women afterradiotherapy for breast cancer. N Engl J Med 2013;368:98798.
Ma C, Zhang W, Lu J,et al. Dosimetriccomparison and evaluation of three radiotherapy techniques for …. Sci Rep 2015;5:12274.
D. ADAM et al. Volumetric modulated arc therapy vs 3D conformal radiotherapy for breast cancer, Romanian Reports in Physics, Vol. 67, No. 3, P. 978-986, 2015
Swamy ST, Radha CA, et al. Feasibilitystudy of DIBH based VMAT for left Breast cancer. Asian Pac J Cancer Prev 2014;15:90338.
Blom Goldman U, Wennberg B,el at. Reductionof radiation pneumonitis by V20constraints in breast cancer. RadiatOncol 2010;5:99.
Sakumi A, Shiraishi K, Onoe T, et al.Singlearc volumetric modulated arc therapy planning for left breastcancer and regional nodes. J Radiat Res 2012;53:1513.
Nichols GP, Fontenot JD, et al Evaluation ofvolumetric modulated arc therapy for postmastectomy treatment.Radiat Oncol 2014;9:66.
Osman SO, Hol S, Poortmans P, et al. Volumetric modulatedarc therapy and breathhold in imageguided locoregional leftsidedbreast irradiation. Radiother Oncol 2014;112:1722.
Shyama P, et al. Comparison of dosimetric parameters of VMAT and 3D-CRTin carcinoma breast, Journal of Cancer Research and Therapeutics 2016; 1005:1009.
Marilyn Stovall, Susan A Smith, et al. Dose to the Contralateral Breast from Radiation Therapy and Risk of Second Primary Breast Cancer in the WECARE Study, Int J Radiat Oncol Biol Phys. 2008 Nov 15; 72(4): 1021-1030.
| Published | 20-02-2020 | |
| Fulltext |
|
|
| Language |
|
|
| Issue | No. 59 (2020) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.2020.59.9 | |
| Keywords | Ung thư vú, Xạ trị sau phẫu thuật, xạ trị tương thích ba chiều, Xạ trị điều biến thể tích cung tròn Breast cancer, Postmastectomy radiotherapy, Three-dimension conformal radiotherapy, Volumetric modulated arc therapy |
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2020 Journal of Clinical Medicine Hue Central Hospital