Dosimetric comparison of left-sided whole breast irradiation with 3D-CRT, IP-IMRT and hybrid IMRT

Xie,Xiaoxue; Ouyang,Shuyu; Wang,Hui; Yang,Wenjuan; Jin,Hekun; Hu,Bingqiang; Shen,Liangfang

doi:10.3892/or.2014.3058

Dosimetric comparison of left-sided whole breast irradiation with 3D-CRT, IP-IMRT and hybrid IMRT

Authors:
- Xiaoxue Xie
- Shuyu Ouyang
- Hui Wang
- Wenjuan Yang
- Hekun Jin
- Bingqiang Hu
- Liangfang Shen
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Affiliations: Department of Radiation Oncology, Hunan Provincial Tumor Hospital and Affiliated Tumor Hospital of Xiangya Medical School, Central South University, Changsha, Hunan 410013, P.R. China, Department of Radiation Oncology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
Published online on: March 5, 2014 https://doi.org/10.3892/or.2014.3058
Pages: 2195-2205

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Abstract

The aim of this study was to compare the dosimetric characteristics of left-sided whole breast irradiation among 3-dimensional conformal radiotherapy (3D-CRT), 4-field inverse-planned intensity-modulated radiotherapy (IP-IMRT) and hybrid IMRT technique (combining 3D-CRT beams and IP-IMRT beams) with respect to target coverage and irradiation of organs at risk. The 3 different planning techniques were analyzed for 8 patients with left-sided breast conserving surgery. Plans were compared on the basis of planning target volume (PTV) dose conformity, homogeneity and the volumes of normal tissues treated based on dose-volume histograms (DVHs). DVHs were calculated for the PTV, heart, and the bilateral lungs, contralateral breast, and soft tissue surrounding the breast PTV (VOB) volume. IP-IMRT and hybrid IMRT techniques comparably improved the PTV dose homogeneity and conformity (CI) significantly, compared to the conventional 3D-CRT technique (P<0.017); the IP-IMRT technique only could additionally benefit patients by decreasing the high-dose (40 Gy) volume for heart and ipsilateral lung compared with the hybrid IMRT technique (P<0.017); the hybrid IMRT plans achieved a further improvement by compromising the increase of low-dose volume (total lung V13, contralateral lung V5, heart V10 and soft tissue surrounding the breast V5) compared with IP-IMRT plans (P<0.017). Hybrid IMRT plans achieved equivalent PTV dose uniformity to IP-IMRT plans and compromised the low-dose volume and requirement of clinic resource between IP-IMRT and 3D-CRT plans, promoting it as a standard practice of left-sided breast irradiation for patients in good-ordered cardiopulmonary health.

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