Abstract
Purpose: The study is aimed to establish the dosimetric characteristics of field-in-field (FiF) technique for carcinoma of breast treatment in Nepal. We assumed that FIF technique may result in improved dose distribution and reduced acute toxicity in these patients. Methods: Forty breast cancer patients participated in this study. A total dose of 50 Gy in 25 fractions was prescribed to the planning target volume. FiF plan was generated in treatment planning system. Dose volume histograms were evaluated for PTV and organs at risks. Several parameters were analyzed for the PTVs and organ at risks (OARs) together with the Conformity index (CI), and the Homogeneity index (HI). Results: The dose coverage of breast volume was achieved. The V95% (volume of 95%) of PTV covered D95% (Dose of 95%). The PTV dose was covered to 49.98 ± 0.9 Gy and 49.81 ± 1.1 Gy for the left and right breast, respectively. The mean lung dose was 14.87 ± 0.91 Gy. The homogeneity index (0.26 ± 0.17 and 0.22 ± 0.13) and conformity index (1.59 ± 0.75 and 1.36 ± 0.45) were analyzed for left and right breast, respectively. Conclusion: The study supports the viability of FiF technique in the treatment of breast cancer in Nepal. The FIF technique enables better dose distribution in the PTV and reduces dose to OARs. The FiF technique provides dosimetric advantages and requires less planning time.
Highlights
Breast cancer represents the most common cancer in women worldwide [1], constituting 24.2% of all malignancies, according to GLOBOCAN statistics [2]
Several parameters were analyzed for the Planning Target Volume (PTV) and organ at risks (OARs) together with the Conformity index (CI), and the Homogeneity index (HI)
This study focused on left and right breast treatment performed in order to evaluate the dose distribution using the FiF radiotherapy technique and correlate the normal tissue toxicity
Summary
Breast cancer represents the most common cancer in women worldwide [1], constituting 24.2% of all malignancies, according to GLOBOCAN statistics [2]. The management of breast cancer is based on tumor and patient characteristics. It involves a multimodality approach and includes a combination of surgery, with or without radiation therapy or systemic therapy. The most common type of radiation used to treat breast cancer is external beam radiation therapy. Radiotherapy has an essential role in the management of breast cancer. The aim is to deliver homogeneous maximum dose to the planning target volume and a minimum dose to surrounding normal tissue
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