Abstract
Purpose: To evaluate the dose distribution of target volume and normal tissues in forward intensity modulated radiotherapy (f‐IMRT) and inverse intensity modulated radiotherapy (IMRT) plans for breast cancer after radical mastectomy. Methods: Ten patients with breast cancer who received radical mastectomy were enrolled in this study. On each patientˈs CT images the supraclavicular, chest wall and internal mammary areas were delineated. F‐IMRT and IMRT plans were performed for each patient. The prescription dose was 50 Gy in 25 fractions. F‐IMRT plans for the supraclavicular and the chest wall area using 6 MV X‐ray irradiation; internal mammary area with 9‐12 MeV electron irradiation, according to the three regions of dose adjust the doses of cold and hot fit. The supraclavicular, chest wall and internal mammary area were considered as a whole target in the IMRT plans, using 6 MV X‐ray. The dose‐volume parameters of target volume and normal tissues, CI and HI of f‐IMRT and IMRT plans were analyzed, using paired t‐test. Results: The target volume coverage of f‐IMRT plans were similar to that of the IMRT plans (93% and 94.5%). The mean CI and mean HI were 0.67±0.02/1.18±0.02 in f‐IMRT and 0.75±0.03/1.14±0.01 in IMRT (P<0.05). The differences of V10, V20, V25, V30 and Dmean of ipsilateral lung were not statistically significant. However, the V15 of ipsilateral lung in IMRT was 4.5% less than that in f‐IMRT, which was statistically significant (P<0.05). There was no significant difference in Dmean and V30 of heart, Dmean of contralateral lung and contralateral breast between two modes. Conclusions: Compared with f‐IMRT, IMRT plans resulted in better conformal dose distribution and homogeneity, with comparable target volume coverage and sparing of lung, heart and contralateral breast.
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