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Breast-Conserving Radiotherapy with Simultaneous Integrated Boost—A Dosimetric Comparison of 3DCRT, VMAT and IMRT: Do We Really have a Better Plan?

  • Bindhu JosephEmail author
  • Vedamanasa Ikkurthi
  • Nisma Farooq
  • K. Nithin
  • C. R. Vijay
  • C. Ramesh
  • V. Lokesh
Original Article
  • 13 Downloads

Abstract

Background and Purpose

The availability of more advanced technology like hypo-fractionation has the potential of being the new standard of care in breast cancer. This study evaluates whether 3DCRT with a field-in-field technique (FIF) and a simultaneous integrated boost (SIB) could provide a dosimetrically comparable plan delivered to VMAT or IMRT.

Materials and Methods

3DCRT-FIF-SIB, VMAT and IMRT-SIB plans were generated for 20 patients. The plans were compared for planning target volume coverage (PTV 95), homogeneity and conformity, dose delivered to lungs, heart and C/L breast.

Results

3DCRT FIF provided better sparing of C/L breast V1 and V5, whole lung V5, p = 0.000. The VMAT plans spared heart V30: (0.1 ± 0.46 vs. 11.5 ± 18.3) p = 0.000 and I/L lung V20: (19.3 ± 5 vs. 32.2 ± 11.1) p = 0.000. It provided a better coverage V95: (97 ± 0.8 vs. 95 ± 2.9) p = 0.002 and sparing of the heart V30: (0.1 ± 0.5 vs. 8.6 ± 11.5) p < 0.002 and lungs I/L V20: (19.3 ± 5.0 vs. 30.7 ± 6.1) p = 0.000. The treatment was faster with less exposure in terms of MU: (529 ± 57.8 vs. 1024 ± 298) p = 0.000.

Conclusions

3DCRT provides a dosimetrically acceptable alternative to more advanced technologies. VMAT and IMRT provide better sparing of heart and lungs. VMAT has a slight benefit of conformity, reduced exposure and shorter treatment time.

Keywords

3DCRT FIF IMRT VMAT SIB 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human and Animal Rights Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Association of Gynecologic Oncologists of India 2019

Authors and Affiliations

  • Bindhu Joseph
    • 1
    • 4
    Email author
  • Vedamanasa Ikkurthi
    • 1
  • Nisma Farooq
    • 1
  • K. Nithin
    • 2
  • C. R. Vijay
    • 3
  • C. Ramesh
    • 3
  • V. Lokesh
    • 1
  1. 1.Department of Radiation OncologyKidwai Memorial Institute of OncologyBangaloreIndia
  2. 2.Department of Medical PhysicistKidwai Memorial Institute of OncologyBangaloreIndia
  3. 3.Department of Epidemiology and BiostatisticsKidwai Memorial Institute of OncologyBangaloreIndia
  4. 4.BangaloreIndia

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