Abstract
Objective: To compare the dosimetric characteristic of tangential field 3D conformal (TF-3DCRT, TF), field-in-field intensity-modulated (FIF-IMRT, FIF) and fixed-field inversely optimized intensity-modulated Radiotherapy (FFIO-IMRT, FFIO) for breast conserving treatment, and explore the benefit and efficiency for the three techniques. Materials and Methods: TF-3DCRT, FIF-IMRT and FFIO-IMRT treatment plans were analyzed for 16 breast patients (8 right-sided and 8 left-sided) after breast-conserving surgery. The target and organs at risk (OARs) were contoured by the same physician in the CT images. The prescription dose was 50Gy/25f. TF-3DCRT and FIF-IMRT were designed using Varian Eclipse Ver10.0 planning system, and FFIO-IMRT in the planning system of Pinnacle Ver9.6. Treatment plans were compared according to dose volume histogram (DVH) analysis in terms of PTV homogeneity and conformity indices (HI and CI) as well as OARs dose and volume parameters, and the efficiency was also evaluated. Results: In all cases, the treatment plans showed statistically significant difference between TF-3DCRT, FIF and FFIO-IMRT. The MUs were 244.9±8.3MU vs 285.9±20.3MU vs 534.0±56.2MU (p<0.001), the CIs of dose distribution and the target were 0.40±0.12 vs 0.48±0.12 vs 0.57±0.12 (p<0.01), and the HIs were 0.20±0.02 vs 0.13±0.02 vs 0.17±0.02 (p<0.01). Compared with TF and FFIO, FIF-IMRT showed smaller in the dose of D2 and volume of V107 and V110 in the target. FFIO-IMRT generally increased the D mean, V10 and V20 of ipsilateral lung, the D1 of contralateral breast and the mean dose of contralateral lung, heart, esophagus, and spinal cord relative to TF and FIF techniques. Conclusion: In breast-conserving RT, FIF-IMRT improved the overall quality of dose distribution and delivery efficiency, and the patients are most likely to benefit from FIF-IMRT.
Highlights
Breast cancer deaths in all malignant tumor of the fifth, its incidence in women’s common malignant tumor in the second, second only to lung cancer, a serious threat to women’s health, and destruction of female sexuality and instrument is beautiful, for patients with physical, psychological and social aspects of a huge impact [1]
D2 is the dose accepted by 2% target volume, D98 is the minimum dose accepted by 98% target volume, D50 Dose accepted for 50% target volume
The general conclusion drawn from these reports is that advanced radiotherapy techniques can improve dose uniformity in tumor target volumes and reduce high-dose areas in the heart and lungs, but more normal tissues are exposed to low-dose radiation
Summary
Breast cancer deaths in all malignant tumor of the fifth, its incidence in women’s common malignant tumor in the second, second only to lung cancer, a serious threat to women’s health, and destruction of female sexuality and instrument is beautiful, for patients with physical, psychological and social aspects of a huge impact [1]. Surgery requires patients to retain their lives, and enhances the quality of life, meets women's demands for virtue, and maintains a more harmonious life. This promotes the value of breast-conserving treatment [2]. In order to improve the postoperative beauty effect and quality of life of female patients, the treatment method of early breast cancer retention has become the standard treatment mode and has been widely used in clinical practice [3].
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