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Article: Breast Cancer Patients Treated by Helical Tomotherapy, Intensity-modulated Radiotherapy, and Volumetric Arc Therapy: Comparison of Lung Doses

TitleBreast Cancer Patients Treated by Helical Tomotherapy, Intensity-modulated Radiotherapy, and Volumetric Arc Therapy: Comparison of Lung Doses
Authors
KeywordsBreast neoplasms
Radiotherapy
Radiotherapy
intensity-modulated
Issue Date2020
PublisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkjr.org
Citation
Hong Kong Journal of Radiology, 2020, v. 23 n. 1, p. 4-11 How to Cite?
AbstractIntroduction:We compared the dosimetry of three different radiotherapy (RT) techniques: helical tomotherapy (TOMO), intensity-modulated RT (IMRT), and volumetric modulated arc therapy (VMAT) in patients with breast cancer when the conventional technique was unworkable. Methods: We enrolled 16 patients that required treatment of residual internal mammary lymph node involvement (n = 9), with a planning target volume (PTV) close to the borders of the tangential fields of the conventional RT technique (n = 5), and with synchronous breast tumours requiring bilateral breast irradiation (n = 2). Planning computed tomography contours of these patients were retrieved, and virtual RT plans of all three techniques were developed for each patient for the purpose of dose comparison, with the objective of achieving optimal dose coverage to the PTV while minimising the lung dose and keeping the heart dose to the internationally recognised safe level. 42.56 Gy in 16 daily fractions was prescribed in all RT plans. Results: The PTV coverage and hot spot dose were comparable among all RT plans. The doses to organs at risk were converted to 2 Gy equivalent using an α/β ratio of 3 for comparison. The mean lung dose (MLD), lung V5, and lung V20 were significantly lower using TOMO (MLD 10.2 Gy, V5: 30.3%, V20: 14.7%), compared with IMRT (MLD 11.9 Gy, p = 0.006; V5: 39.7%, p < 0.001; V20: 20.6%, p = 0.001) and VMAT (MLD 15.4 Gy, p < 0.001; V5: 52.3%, p < 0.001; V20: 27%, p < 0.001). The mean heart dose was significantly lower using IMRT (12.1 Gy) compared with TOMO (15.5 Gy, p = 0.017) and VMAT (14.9 Gy, p = 0.005). Conclusion: TOMO achieved lower lung doses, in terms of V5, V20 and MLD, compared with IMRT and VMAT.
Persistent Identifierhttp://hdl.handle.net/10722/294035
ISSN
2015 SCImago Journal Rankings: 0.113
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorHo, WK-
dc.contributor.authorNgan, RKC-
dc.contributor.authorYip, CWY-
dc.contributor.authorLee, FKH-
dc.contributor.authorLui, JCF-
dc.date.accessioned2020-11-23T08:25:25Z-
dc.date.available2020-11-23T08:25:25Z-
dc.date.issued2020-
dc.identifier.citationHong Kong Journal of Radiology, 2020, v. 23 n. 1, p. 4-11-
dc.identifier.issn2223-6619-
dc.identifier.urihttp://hdl.handle.net/10722/294035-
dc.description.abstractIntroduction:We compared the dosimetry of three different radiotherapy (RT) techniques: helical tomotherapy (TOMO), intensity-modulated RT (IMRT), and volumetric modulated arc therapy (VMAT) in patients with breast cancer when the conventional technique was unworkable. Methods: We enrolled 16 patients that required treatment of residual internal mammary lymph node involvement (n = 9), with a planning target volume (PTV) close to the borders of the tangential fields of the conventional RT technique (n = 5), and with synchronous breast tumours requiring bilateral breast irradiation (n = 2). Planning computed tomography contours of these patients were retrieved, and virtual RT plans of all three techniques were developed for each patient for the purpose of dose comparison, with the objective of achieving optimal dose coverage to the PTV while minimising the lung dose and keeping the heart dose to the internationally recognised safe level. 42.56 Gy in 16 daily fractions was prescribed in all RT plans. Results: The PTV coverage and hot spot dose were comparable among all RT plans. The doses to organs at risk were converted to 2 Gy equivalent using an α/β ratio of 3 for comparison. The mean lung dose (MLD), lung V5, and lung V20 were significantly lower using TOMO (MLD 10.2 Gy, V5: 30.3%, V20: 14.7%), compared with IMRT (MLD 11.9 Gy, p = 0.006; V5: 39.7%, p < 0.001; V20: 20.6%, p = 0.001) and VMAT (MLD 15.4 Gy, p < 0.001; V5: 52.3%, p < 0.001; V20: 27%, p < 0.001). The mean heart dose was significantly lower using IMRT (12.1 Gy) compared with TOMO (15.5 Gy, p = 0.017) and VMAT (14.9 Gy, p = 0.005). Conclusion: TOMO achieved lower lung doses, in terms of V5, V20 and MLD, compared with IMRT and VMAT.-
dc.languageeng-
dc.publisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkjr.org-
dc.relation.ispartofHong Kong Journal of Radiology-
dc.rightsHong Kong Journal of Radiology. Copyright © Hong Kong Academy of Medicine Press.-
dc.subjectBreast neoplasms-
dc.subjectRadiotherapy-
dc.subjectRadiotherapy-
dc.subjectintensity-modulated-
dc.titleBreast Cancer Patients Treated by Helical Tomotherapy, Intensity-modulated Radiotherapy, and Volumetric Arc Therapy: Comparison of Lung Doses-
dc.typeArticle-
dc.identifier.emailNgan, RKC: rkcngan@hku.hk-
dc.identifier.authorityNgan, RKC=rp02371-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.12809/hkjr2016959-
dc.identifier.scopuseid_2-s2.0-85086102854-
dc.identifier.hkuros319718-
dc.identifier.volume23-
dc.identifier.issue1-
dc.identifier.spage4-
dc.identifier.epage11-
dc.identifier.isiWOS:000524980900003-
dc.publisher.placeHong Kong-
dc.identifier.issnl2223-6619-

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