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Left-sided breast radiotherapy after conservative surgery: comparison of techniques between volumetric modulated arc therapy, forward-planning intensity-modulated radiotherapy and conventional technique

Published online by Cambridge University Press:  15 November 2016

Upendra Kumar Giri ,
Biplab Sarkar ,
Kanan Jassal ,
Anusheel Munshi ,
Tharmar Ganesh ,
Bidhu Mohanti  and
Anirudh Pradhan
Upendra Kumar Giri*
Affiliation:
Department of Radiation Oncology, Fortis Memorial Research Institute, Gurgaon, Haryana, India
Biplab Sarkar
Affiliation:
Department of Radiation Oncology, Fortis Memorial Research Institute, Gurgaon, Haryana, India
Kanan Jassal
Affiliation:
Department of Radiation Oncology, Fortis Memorial Research Institute, Gurgaon, Haryana, India
Anusheel Munshi
Affiliation:
Department of Radiation Oncology, Fortis Memorial Research Institute, Gurgaon, Haryana, India
Tharmar Ganesh
Affiliation:
Department of Radiation Oncology, Fortis Memorial Research Institute, Gurgaon, Haryana, India
Bidhu Mohanti
Affiliation:
Department of Radiation Oncology, Fortis Memorial Research Institute, Gurgaon, Haryana, India
Anirudh Pradhan
Affiliation:
Department of Mathematics, GLA University, Mathura, Uttar Pradesh, India
*
Correspondence to: Upendra Kumar Giri, Department of Radiation Oncology, Fortis Memorial Research Institute, Gurgaon, Haryana 122002, India. Tel: +91 9650778852. E-mail: upendragiribhu@gmail.com
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Abstract

Objective

This study was conducted for comparison of techniques between volumetric modulated arc therapy (VMAT), forward-planning intensity-modulated radiotherapy (FIMRT) and conventional technique for left-sided breast radiotherapy after conservative surgery.

Methods

In all, 20 postoperative left breast carcinoma patients were included in this study. In all plans the planning target volume (PTV) was the breast tissue with appropriate margin as per our institutional protocol. The contouring was done on a Monaco Sim (V5.00.02) contouring workstation. All patient were planned using partial arc VMAT in Monaco treatment planning system (TPS) (V5.00.02) and treated on Elekta Synergy linear accelerator. The 3D conformal radiotherapy (3DCRT) and FIMRT planning were done in CMS XIO (V5.00.01.1) TPS. The 3DCRT planning consisted of conventional medial and tangential wedge portals with multileaf collimator field shaping conforming to the target volume. For all the plans generated the following metrics were scored: V105%, V100%, V95%, mean dose (for PTV), V5%, V20%, D2cc and mean dose (for organs at risk).

Results

The mean PTV volume for 20 patients was 1,074·6±405·1 cc. The highest PTV dose coverage was observed in the 3DCRT technique with 94·1±1·8% of the breast PTV receiving 95% of the prescription dose (V95%). However, it was also observed that this technique resulted in 21·3±10% of the PTV receiving more than 105% of the prescription dose (V105%), which was highest among the three techniques. In contrast, VMAT yielded lowest V95% of 93·0±1·8 and 3·3±5·5% of V105%.

Conclusion

This study concluded equivalent result between FIMRT and VMAT. However, VMAT was found to be the choice of radiotherapy technique as it produces lesser dose distribution to heart compared with any other technique.

Keywords

3DCRTFIMRTleft-sided breast radiotherapyvolumetric modulated arc therapy (VMAT)
Type
Technical Note
Information
Journal of Radiotherapy in Practice , Volume 16 , Issue 1 , March 2017 , pp. 101 - 108
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Copyright
© Cambridge University Press 2016 

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