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Dosimetric analysis of intensity-modulated radiotherapy and three-dimensional conformal radiotherapy for chest wall irradiation in breast cancer patients

Published online by Cambridge University Press:  01 December 2015

Mehlam Kausar ,
Om Prakash Gurjar ,
Priyusha Bagdare ,
Krishna Lal Gupta ,
Virendra Bhandari ,
Ayush Naik ,
Pulkit Nag  and
Jeetendra Kancherla
Mehlam Kausar
Affiliation:
Roentgen-SAIMS Radiation Oncology Centre, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
Om Prakash Gurjar*
Affiliation:
Roentgen-SAIMS Radiation Oncology Centre, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
Priyusha Bagdare
Affiliation:
Roentgen-SAIMS Radiation Oncology Centre, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
Krishna Lal Gupta
Affiliation:
Roentgen-SAIMS Radiation Oncology Centre, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
Virendra Bhandari
Affiliation:
Roentgen-SAIMS Radiation Oncology Centre, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
Ayush Naik
Affiliation:
Roentgen-SAIMS Radiation Oncology Centre, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
Pulkit Nag
Affiliation:
Roentgen-SAIMS Radiation Oncology Centre, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
Jeetendra Kancherla
Affiliation:
Roentgen-SAIMS Radiation Oncology Centre, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
*
Correspondence to: Dr Om Prakash Gurjar, Roentgen-SAIMS Radiation Oncology Centre, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh 453111, India. Tel: 91 731 423 1728. E-mail: ominbarc@gmail.com
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Abstract

Background

For chest wall irradiation in breast cancer patients, three-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiotherapy (IMRT) have made tremendous changes in treatment delivery.

Purpose

The purpose of this study is to compare the dosimetric parameters in IMRT and 3DCRT plans.

Materials and methods

IMRT and 3DCRT plans were generated for 25 randomly selected postmastectomy breast cancer patients. The prescribed dose (PD) was 50 Gray (Gy) in 25 fractions (#) at the rate of 2 Gy/# with 5#/week. Dose volume histogram was evaluated for planning target volume (PTV) coverage and dose to organs at risk (OARs). All the dosimetric parameters were compared using unpaired student’s t-test.

Results

PTV coverage was significantly better in IMRT, although the 90% of PTV was well covered by 90% of PD in all plans by both the techniques. Homogeneity index and conformity index were better in IMRT. V5 Gy and Dmean of contralateral lung, contralateral breast and heart (right side chest wall cases) were found to be lesser in 3DCRT compared with that in IMRT. However, there was no significant difference in V20 Gy of ipsilateral lung and V25 Gy of heart (left side chest wall cases) in all the plans by both the techniques.

Conclusion

Adequate target coverage was achieved by both the techniques, however, dose to OARs were lesser in 3DCRT plans as compared with that in IMRT plans. Thus, it can be concluded that 3DCRT is as efficient as IMRT for the chest wall irradiation.

Keywords

chest wall irradiationdosimetric parametersintensity-modulated radiotherapyipsilateral lungthree-dimensional conformal radiotherapy
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 15 , Issue 1 , March 2016 , pp. 30 - 37
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Copyright
© Cambridge University Press 2015 

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