Benefits and Limitations of Volumetric Modulated Arc Therapy in Treating Bilateral Breast Cancer with Regional Lymph Nodes

• 作者: C. De Wagter K. Vandeputte R. P. Srivastava
• 来源期刊: 乳腺癌(英文)
• 学科: 医学
• 关键词: Bilateral Breast Cancer (BCC) Volumetric Modulated Arc Therapy (VMAT) Field in Field (FiF) Planning Target Volume (PTV) Organ’s Volume That Receives x Gy of Dose (V_xGy)
• 年，卷（期）: 2020,（4）
• 页码范围: 119-126
• 页数: 8页
• 分类号: R73

摘要

<strong>Purpose:</strong><span style="font-family:""><span style="font-family:Verdana;"> The study was performed comparing dosimetric characteristics of volumetric modulated arc therapy (VMAT) and field-in-field (FiF) techniques on a patient with synchronous bilateral breast carcinoma. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> The patients with bilateral breast cancer treatment were included in this study. A total dose of 40.05 Gy in 15 fractions was prescribed to the Planning Target Volume (PTV) of the whole bilateral breast cancer with the supraclavicular and infraclavicular nodes, with a complementary boost of 10 Gy in 4 fractions to the surgical bed (PTV</span>_{<span style="font-family:Verdana;">boost</span>}<span style="font-family:Verdana;">). For both radiotherapy techniques, several V</span>_{<span style="font-family:Verdana;">xGy</span>}<span style="font-family:Verdana;"> parameters were analyzed for the PTVs, together with the Conformity index (CI), the Homogeneity index (HI) and the critical organs at risk (OARs), lungs and heart. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The patient was treated by the VMAT technique and the daily treatment time was less than 20 minutes with daily CBCT imaging. In the VMAT plan, the PTV 95% dose covered 38.89 ± 0.81 Gy, compared to 37.26 ± 1.02 Gy in the FiF technique. The VMAT plan improved the dose homogeneity index and lower dose in lung towards high dose region. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The study demonstrates the viability of the VMAT technique in the treatment of bilateral breast cancer. The introduced single isocentric VMAT technique is fast to deliver and it increases the dose homogeneity of the target volume with some limitations. The treatment was well tolerated, without interruption of the treatment courses caused by treatment</span></span><span styl