Dosimetric comparison of left-sided whole breast irradiation with 3DCRT, forward-planned IMRT, inverse-planned IMRT, helical tomotherapy, and topotherapy

Leah K. Schubert, Vinai Gondi, Evan Sengbusch, David C. Westerly, Emilie T. Soisson, Bhudatt R. Paliwal, Thomas Rockwell MacKie, Minesh P. Mehta, Rakesh R. Patel, Wolfgang A. Tomé, George M. Cannon

Research output: Contribution to journalArticle

98 Scopus citations

Abstract

Background and purpose: To compare left-sided whole breast conventional and intensity-modulated radiotherapy (IMRT) treatment planning techniques. Materials and methods: Treatment plans were created for 10 consecutive patients. Three-dimensional conformal radiotherapy (3DCRT), forward-planned IMRT (for-IMRT), and inverse-planned IMRT (inv-IMRT) used two tangent beams. For-IMRT utilized up to four segments per beam. For helical tomotherapy (HT) plans, beamlet entrance and/or exit to critical structures was blocked. Topotherapy plans, which used static gantry angles with simultaneous couch translation and inverse-planned intensity modulation, used two tangent beams. Plans were normalized to 50 Gy to 95% of the retracted PTV. Results: Target max doses were reduced with for-IMRT compared to 3DCRT, which were further reduced with HT, topotherapy, and inv-IMRT. HT resulted in lowest heart and ipsilateral lung max doses, but had higher mean doses. Inv-IMRT and topotherapy reduced ipsilateral lung mean and max doses compared to 3DCRT and for-IMRT. Conclusions: All modalities evaluated provide adequate coverage of the intact breast. HT, topotherapy, and inv-IMRT can reduce high doses to the target and normal tissues, although HT results in increased low doses to large volume of normal tissue. For-IMRT improves target homogeneity compared with 3DCRT, but to a lesser degree than the inverse-planned modalities.

Original languageEnglish (US)
Pages (from-to)241-246
Number of pages6
JournalRadiotherapy and Oncology
Volume100
Issue number2
DOIs
StatePublished - Aug 1 2011
Externally publishedYes

Keywords

  • Breast cancer
  • IMRT
  • Tangents
  • Tomotherapy
  • Topotherapy

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

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  • Cite this

    Schubert, L. K., Gondi, V., Sengbusch, E., Westerly, D. C., Soisson, E. T., Paliwal, B. R., MacKie, T. R., Mehta, M. P., Patel, R. R., Tomé, W. A., & Cannon, G. M. (2011). Dosimetric comparison of left-sided whole breast irradiation with 3DCRT, forward-planned IMRT, inverse-planned IMRT, helical tomotherapy, and topotherapy. Radiotherapy and Oncology, 100(2), 241-246. https://doi.org/10.1016/j.radonc.2011.01.004