Browse > Article

Dosimetric Comparison of Left-sided Whole Breast Irradiation using a Virtual Bolus with VMAT and static IMRT  

Lim, Kyeong Jin (Department of Proton Therapy Center, National Cancer Center)
Kim, Tae Woan (Department of Proton Therapy Center, National Cancer Center)
Jang, Yo Jong (Department of Proton Therapy Center, National Cancer Center)
Yang, Jin Ho (Department of Proton Therapy Center, National Cancer Center)
Lee, Seong Hyeon (Department of Proton Therapy Center, National Cancer Center)
Yeom, Du Seok (Department of Proton Therapy Center, National Cancer Center)
Kim, Seon Yeong (Department of Proton Therapy Center, National Cancer Center)
Publication Information
The Journal of Korean Society for Radiation Therapy / v.31, no.2, 2019 , pp. 51-63 More about this Journal
Abstract
Purpose: Radiation therapy for breast cancer should consider the change in breast shape due to breathing and swelling. In this study, we evaluate the benefit of using virtual bolus for IMRT of left breast cancer. Materials and methods: 10 patients with early breast cancer who received radiation therapy after breastconserving surgery compared the VMAT and IMRT plans using the virtual bolus method and without using it. The first analysis compared the V95%, HI, CI of treatment volume, Dmean, V5, V20, V30 of ipsilateral lung, and Dmean of heart in VMAT plan made using the virtual bolus method(VMAT_VB) to the plan without using it(VMAT_NoVB) in case there is no change in the breast. In IMRT, the same method was used. The second analysis compared TCP and NTCP based on each treatment plan in case there is 1cm expansion of treatment volume. Result: If there is no change in breast, V95% in VB Plan(VMAT_VB, IMRT_VB) and NoVB Plan(VMAT_NoVB, IMRT_NoVB) is all over 99% on each treatment plan. V95% in VMAT_NoVB and VMAT_VB is 99.80±0.17% and 99.75±0.12%, V95% in IMRT_NoVB and IMRT_VB is 99.67±0.26% and 99.51±0.15%. Difference of HI, CI is within 3%. OAR dose in VB plan is a little high than NoVB plan, and did not exceed guidelines. If there is 1cm change in breast, VMAT_NoVB and IMRT_NoVB are less effective for treatment. But VMAT_VB and IMRT_VB continue similar treatment effect compared in case no variation of breast. Conclusion: This study confirms the benefit of using a virtual bolus during VMAT and IMRT to compensate potential breast shape modification.
Keywords
Virtual bolus; Left breast; VMAT; IMRT; Edema;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Darby S, McGale P, Correa C, et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet 2011;378:1707-16.   DOI
2 Clake M, Collins R, Darby S, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: An overview of the randomised trials. Lancet 2005;366(9503):2087-2106. http:// doi.org/10.1016/S0140-6736(05)67887-74.   DOI
3 Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 2002;347(16):1233-41.   DOI
4 Liu H, Chen X, He Z, Li J. Evaluation of 3D-CRT, IMRT and VMAT radiotherapy plans for left breast cancer based on clinical dosimetric study. Comput Med Imaging Graph 2016;54:1-5.   DOI
5 Haciislamoglu E, Colak F, Canyilmaz E, et al. Dosimetric comparison of left-sided whole-breast irradiation with 3DCRT, forward-planned IMRT, inverse-planned IMRT, helical tomotherapy, and volumetric arc therapy. Phys Med 2015;31:360-7.   DOI
6 Schubert LK, Gondi V, Senbusch E, et al. Dosimetric comparison of left-sided whole breast irradiation with 3DCRT, forward-planned IMRT, inverse-planned IMRT, helical tomotherapy, and topotherapy. Radiother Oncol 2011;100:241-6.   DOI
7 Coon AB, Dickler A, Kirk MC et al. Tomotherapy and multifield intensity-modulated radiotherapy planning reduce cardiac doses in left-sided breast cancer patients with unfavorable cardiac anatomy. Int J Radiat Oncol Biol Phys. 2010;78(1):104-10.   DOI
8 Michalski A, Atyeo J, Cox J, Rinks M, et al. Inter- and intra-fraction motion during radiation therapy to the whole breast in the supine position: a systematic review. J Med Imaging Radiat Oncol 2012;56:499-509.   DOI
9 Jones S, Fitzgerald R, Owen R, Ramsay J, et al. Quantifying intra- and inter-fractional motion in breast radiotherapy. J Med Radiat Sci 2015;62:40-6.   DOI
10 Back M, Guerrieri M, Wratten C, et al. Impact of Radiation Therapy on Acute Toxicity in Breast Conservation Therapy for Early Breast Cancer. Clin Oncol 2004;16:12-6.   DOI
11 Verbelen H, Gebruers N, Beyers T, et al. Breast edema in breast cancer patients following breast-conserving surgery and radiotherapy: a systematic review. Breast Cancer Res Treat 2014;147:463-71.   DOI
12 Tyran M, Tallet A, Resbeut M, et al. Safety and benefit of using a virtual bolus during treatment planning for breast cancer treated with arc therapy. J Appl Clin Med Phys 2018;19(5):463-72.   DOI
13 Prabhakar R, Rath GK, Julka PK, et al. Reproducibility of tangential breast fields using online electronic portal images. Rep Pract Oncol Radiother 2007;12:323-8.   DOI
14 Sankar A, Velmurugan J. Different intensity extension methods and their impact on entrance dose in breast radiotherapy: A study. J Med Phys 2009;34(4):200-5.   DOI
15 Moliner G, Izar F, Ferrand R, et al. Virtual bolus for total body irradiation treated with helical tomotherapy. J Appl Clin Med Phys 2015;16(6):164-176.   DOI
16 A. Lirette, J. Pouliot, M. Aubin, et al. The role of electronic portal imaging in tangential breast irradiation: a prospective study. Radiother Oncol 1995;37:241-5.   DOI
17 Giorgia N, Antonella F, Alessandro C, et al. Planning strategies in volumetric modulated are therapy for breast. Med. Phys. 2011;38:4025-31.   DOI
18 Sankar A, Velmurugan J. Different intensity extension methods and their impact on entrance dose in breast radiotherapy; A study. J Med Phys 2009;34:200-5.   DOI
19 Moliner G, Izar F, Ferrand R, et al. Virtual bolus for total body irradiation treated with helical tomotherapy. J Appl Clin Med Phys 2015;16:164-76.   DOI