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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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References

1.Fact sheets by cancer atlas. http://globocan.iarc.fr/pages/fact_sheets_cancer.aspx. Accessed on 3 August 2015.Google Scholar
2.Veronesi, U, Marubini, E, Marian, Let al. Radiotherapy after breast conserving surgery in breast cancer: long term result of randomized trial. Ann Oncol 2001; 12: 997–1003.CrossRefGoogle ScholarPubMed
3.Recht, A. Clinical Radiation Oncology, 2nd edition. Breast cancer: Stages T1 and T2. Elsevier Publisher: Churchill Livingstone, 2007: 1475–1495.Google Scholar
4.Khalifa, A, Somangali, SS, Satyapal, N. Comparative study of two-dimensional and three-dimensional planning for external irradiation after breast conservation surgery. New Egypt J Med 2006; 34: 63–70.Google Scholar
5.Murthy, KK, Sivakumar, SS, Davis, CA, Ravichandran, R, El Ghamrawy, K. Optimization of dose distribution with multi-leaf collimator using field-in-field technique for parallel opposing tangential beams of breast cancers. J Med Phys 2008; 33: 60–63.Google ScholarPubMed
6.Wilfried, DN, Yan, W, Gary, E. Practical IMRT Planning. (Chapter 5). In: Thomas B, Rupert Schmidt U, Wilfried DN, David EW (eds). Image-Guided IMRT. New York, NY: Springer Publisher, 2006: 48–50.Google Scholar
7.Rudra, S, Al-Hallaq, HA, Feng, C, Chmura, SJ, Hasan, Y. Effect of RTOG breast/chest wall guidelines on dose-volume histogram parameters. J Appl Clin Med Phys 2014; 15: 4547.CrossRefGoogle ScholarPubMed
8.Gurjar, OP, Mishra, SP. Dosimetric analysis of intensity modulated radiotherapy plans having one or more pairs of parallel opposed beams among the set of beams in some special cases. Radiat Prot Environ 2013; 36: 138–142.CrossRefGoogle Scholar
9.Panettieri, V, Barsoum, P, Westermark, M, Brualla, L, Lax, I. AAA and PBC calculation accuracy in the surface build-up region in tangential beam treatments. Phantom and breast case study with the Monte Carlo code PENELOPE. Radiother Oncol 2009; 93: 94–101.CrossRefGoogle ScholarPubMed
10.Rudat, V, Alaradi, AA, Mohamed, A, Ai-Yahya, K, Altuwaijri, S. Tangential beam IMRT versus tangential beam 3D-CRT of the chest wall in postmastectomy breast cancer patients: a dosimetric comparison. Radiat Oncol 2011; 6: 26.CrossRefGoogle ScholarPubMed
11.Al Rahbi, ZS, Al Mandhari, Z, Ravichandran, Ret al. Dosimetric comparison of intensity modulated radiotherapy isocentric field plans and field in field (FIF) forward plans in the treatment of breast cancer. J Med Phys 2013; 38: 22–29.Google ScholarPubMed
12.Li, W, Chen, J, Zhang, Z. IMRT versus 3D-CRT for postmastectomy irradiation of chest wall and regional nodes: a population-based comparison of normal lung dose. Int J Radiat Oncol Biol Phys 2015; 92: 721–731.Google Scholar
13.Yang, B, Wei, XD, Zhao, YT, Ma, CM. Dosimetric evaluation of integrated IMRT treatment of the chest wall and supraclavicular region for breast cancer after modified radical mastectomy. Med Dosim 2014; 39: 185–189.CrossRefGoogle ScholarPubMed
14.Ayata, HB, Güden, M, Ceylan, C, Kücük, N, Engin, K. Comparison of dose distributions and organs at risk (OAR) doses in conventional tangential technique (CTT) and IMRT plans with different numbers of beam in left-sided breast cancer. Rep Pract Oncol Radiother 2011; 16: 95–102.CrossRefGoogle ScholarPubMed
15.George, R, Keall, PJ, Kini, VR, Vedam, SS, Siebers, JV, Wu, Q. Quantifying the effect of intrafraction motion during breast IMRT planning and dose delivery. Med Phys 2003; 30: 552–562.CrossRefGoogle ScholarPubMed
16.Van der Laan, HP, Korevaar, EW, Dolsma, WV, Maduro, JH, Langendijk, JA. Minimising contralateral breast dose in post-mastectomy intensity-modulated radiotherapy by incorporating conformal electron irradiation. Radiother Oncol 2010; 93: 235–240.CrossRefGoogle Scholar