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External beam accelerated partial breast irradiation: dosimetric assessment of conformal and three different intensity modulated techniques Cover

External beam accelerated partial breast irradiation: dosimetric assessment of conformal and three different intensity modulated techniques

Radiology and Oncology
Volume 53 (2019): Issue 1 (March 2019)
By: ,  ,  ,   and    
Open Access
|Jan 2019
Figures & tables

Figures & Tables

Figure 1

Typical beam arrangements in 3D-CRT (A), SS (B), SW (C) and RA (D) treatment plans.

Figure 2

Representative dose distributions for a left sided case with 3D-CRT (A), SS (B), SW (C) and RA (D).

Table 1

Quality indices and total number of monitor units of the four irradiation techniques

3D-CRTSSSWRA3D-CRT vs. SS3D-CRT vs. SW3D-CRT vs. RASS vs. SWSS vs. RASW vs. RA
PTVevalV 95%99.599.899.899.80.96n.sn.sn.sn.sn.sn.s
V 90%1001001001000.875n.sn.sn.sn.sn.sn.s
CTVV 95%99.91001001000.001n.sn.sn.sn.sn.sn.s
V 90%1001001001000.123n.sn.sn.sn.sn.sn.s
HI0.0680.0740.0580.081<0.001n.sp<0.05p<0.05p<0.05n.sp<0.05
CN0.60.80.820.89<0.001p<0.05p<0.05p<0.05p<0.05p<0.05p<0.05
PQI0.50.360.340.43<0.001p<0.05p<0.05p<0.05n.sp<0.05p<0.05
MU67781410771136<0.001n.sp<0.05p<0.05p<0.05p<0.05n.s

[i] 3D-CRT = three dimensional conformal radiotherapy; n.s. = not significant; RA = intensity-modulated arc therapy; SS and SW = „step and shoot” and „sliding window” intensity-modulated radiotherapy

Table 2

Dose to the organs at risk

3D-CRTSSSWRA3D-CRT vs. SS3D-CRT vs. SW3D-CRT vs. RASS vs. SWSS vs. RASW vs. RA
V 100%14.313.912.112.7<0.001n.sp<0.05p<0.05p<0.05p<0.05n.s
IpsilateralV 75%31.526.125.821<0.001p<0.05p<0.05p<0.05n.sp<0.05p<0.05
breastV50%47.540.239.931.6<0.001p<0.05p<0.05p<0.05n.sp<0.05p<0.05
Dmax105.3108.2106.3110.3<0.001p<0.05n.sp<0.05p<0.05p<0.05p<0.05
V 10%13.128.12836<0.001p<0.05p<0.05p<0.05n.sp<0.05p<0.05
IpsilateralV30%3.93.63.66<0.001n.sn.sp<0.05n.sp<0.05p<0.05
lungV40%2.61.91.93<0.001p<0.05p<0.05n.sn.sp<0.05p<0.05
MLD5.67.47.49.9<0.001p<0.05p<0.05p<0.05n.sp<0.05p<0.05
Heart (leftMHD2.42.92.85.4<0.001n.sn.sp<0.05n.sp<0.05n.s
sided tumour)V5%8.719.317.538.9<0.001n.sn.sp<0.05n.sn.sp<0.05
V15%31.51.27.80.043n.sn.sn.sn.sn.sp<0.05
Heart (rightMHD0.81.61.63<0.001n.sn.sp<0.05n.sp<0.05p<0.05
sidedV5%1.38.17.822.2<0.001p<0.05n.sp<0.05n.sn.sp<0.05
tumour)V15%0.60.10.20.50.711n.sn.sn.sn.sn.sn.s
V5%03.43.29.6<0.001p<0.05p<0.05p<0.05n.sp<0.05p<0.05
ContralateralV10%00.10.10.10.001n.sn.sn.sn.sn.sn.s
lungD5%0.5445.4<0.001p<0.05p<0.05p<0.05n.sp<0.05p<0.05
D10%0.43.23.14.7<0.001p<0.05p<0.05p<0.05n.sp<0.05p<0.05
V5%0.73.13.11.9<0.001p<0.05p<0.05p<0.05n.sn.sn.s
ContralateralV10%0.30.20.20.00.013n.sn.sn.sn.sn.sn.s
breastD5%1.23.83.73.8<0.001p<0.05p<0.05p<0.05n.sn.sn.s
Dmax5.68.58.57.8<0.001p<0.05p<0.05p<0.05n.sn.sn.s

[i] 3D-CRT = three dimensional conformal radiotherapy; MHD = mean heart dose; MLD = mean lung dose; n.s. = non-significant; RA = intensity-modulated arc therapy; SS and SW = „step and shoot” and „sliding window” intensity-modulated radiotherapy

Table 3

Comparison between our and other 3D-CRT data published in APBI studies

VPTV (ccm)VPTV / VIBV95% (%)V100%V50%V50%MHD (cGy)V5% (%)MLD (cGy)V30% (%)
Patel et al.20n.an.an.a2652n.an.an.a370n.a
Moon et al.26n.a0.1799.932.857.640.9n.an.an.an.a
Qiu et al.21236.2n.an.a20.346.8n.a76.16.4193.24.4
Essers et al.22176.4n.a96.4n.an.a23.220015.9370n.a
Rusthoven et al.28187.50.2439619.94734.5n.an.an.an.a
Current work155.50.16899.514.347.539.690.38.7205.33.9

[i] MHD = mean heart dose; MLD = mean lung dose; VIB = volume of ipsilateral breast

Table 4

Comparison between our and other IMRT data published in APBI studies

VPTV (ccm)VPTV / VIBV95% (%)V100%V50%V50%MHD (cGy)V5% (%)MLD (cGy)V30% (%)
Moon et al.26

graphic/j_raon-2019-0001_eq_003.png

n.a0.1799.427.250.333.3n.an.an.an.a
Qiu et al.21236.2n.an.a17.345.3n.a35.90.4123.61.4
Livi et al.271230.2196n.an.a37.5n.an.an.a9.7
Bergom et al.252430.1499.116.239.9n.an.a14.6n.a4.6
Rusthoven et al.28187.50.24388.89.442.128.1n.an.an.an.a
Current work

graphic/j_raon-2019-0001_eq_004.png

155.50.16899.812.139.929.6103.617.5272.13.6
Qiu et al.21236.2n.an.a18.244.9n.a54.411482
Essers et al.22176.4n.a98.9n.an.a19.71004.3190n.a
Current work155.50.16899.812.731.619.8198.138.9364.76

[i] MHD = mean heart dose; MLD = mean lung dose; VIB = volume of ipsilateral breast

DOI: https://doi.org/10.2478/raon-2019-0001 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
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Language: English
Page range: 123 - 130
Submitted on: Sep 27, 2018
Accepted on: Nov 29, 2018
Published on: Jan 19, 2019
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
accelerated partial breast irradiation,
dosimetric evaluation,
IMRT,
RapidArc
Related subjects:
Medicine,
Clinical medicine,
Radiology

© 2019 Gábor Stelczer, Tibor Major, Norbert Mészáros, Csaba Polgár, Csilla Pesznyák, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

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