Abstract
BackgroundTo be less resource intensive, we developed a template-based breast IMRT technique (TB-IMRT). This study aims to compare resources and dose distribution between TB-IMRT and conventional breast radiation (CBR).MethodsTwenty patients with early stage breast cancer were planned using CBR and TB-IMRT. Time to plan, coverage of volumes, dose to critical structures and treatment times were evaluated for CBR and TB-IMRT. Two sided-paired t tests were used.ResultsTB-IMRT planning time was less than CBR (14.0 vs 39.0 min, p < 0.001). Fifteen patients with CBR needed 18 MV, and 11 of these were planned successfully with TB-IMRT using 6 MV. TB-IMRT provided better homogeneity index (0.096 vs 0.124, p < 0.001) and conformity index (0.68 vs 0.59, p = 0.003). Dose to critical structures were comparable between TB-IMRT and CBR, and treatment times were also similar (6.0 vs 7.8 min, p = 0.13).ConclusionsTB- IMRT provides reduction of planning time and minimizes the use of high energy beams, while providing similar treatment times and equal plans compared to CBR. This technique permits efficient use of resources with a low learning curve, and can be done with existing equipment and personnel.
Highlights
Breast cancer is the most common invasive female cancer in North America and early stage disease comprises the majority of cases
template-based breast intensity modulated radiation therapy (IMRT) technique (TB-IMRT) plans were done in 14.0 min (7.9-19.4), which was less than conventional breast radiation (CBR) planning time (14.0 vs 39.0 min, p < 0.001). 15 patients with CBR needed 18 MV and 11 of these were planned successfully with IMRT using only 6 MV
The average total beam-on time for these 20 patients with CBR plans were similar to another set of 20 patients with TB-IMRT plans (6.0 vs 7.8 min, p = 0.13)
Summary
Breast cancer is the most common invasive female cancer in North America and early stage disease comprises the majority of cases. Radiation is a crucial component of therapy for women with early stage breast cancer. Radiation reduces breast cancer recurrence rates by twothirds, with an associated survival benefit as well [1,2]. Radiation practice has shifted from two-dimensional therapy based on conventional simulator and anatomical landmarks to a three-dimensional approach using CT planning. Radiation advances have made way for breast intensity modulated radiation therapy (IMRT) to further improve the planning process and delivery of radiation. To be less resource intensive, we developed a template-based breast IMRT technique (TB-IMRT). This study aims to compare resources and dose distribution between TB-IMRT and conventional breast radiation (CBR)
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