11 27

Cited 0 times in

Dosimetric Comparison of Radiation Techniques for Comprehensive Regional Nodal Radiation Therapy for Left-Sided Breast Cancer: A Treatment Planning Study

Authors
 Heejoo Ko  ;  Jee Suk Chang  ;  Jin Young Moon  ;  Won Hee Lee  ;  Chirag Shah  ;  Jin Sup Andy Shim  ;  Min Cheol Han  ;  Jong Geol Baek  ;  Ryeong Hwang Park  ;  Yong Bae Kim  ;  Jin Sung Kim 
Citation
 FRONTIERS IN ONCOLOGY, Vol.11 : 645328, 2021-04 
Journal Title
FRONTIERS IN ONCOLOGY
Issue Date
2021-04
Keywords
breast neoplasms ; continuous positive airway pressure ; intensity-modulated ; proton therapy ; radiotherapy
Abstract
Purpose: How modern cardiac sparing techniques and beam delivery systems using advanced x-ray and proton beam therapy (PBT) can reduce incidental radiation exposure doses to cardiac and pulmonary organs individually or in any combination is poorly investigated. Methods: Among 15 patients with left-sided breast cancer, partial wide tangential 3D-conformal radiotherapy (3DCRT) delivered in conventional fractionation (CF) or hypofractionated (HF) schedules; PBT delivered in a CF schedule; and volumetric modulated arc therapy (VMAT) delivered in an HF schedule, each under continuous positive airway pressure (CPAP) and free-breathing (FB) conditions, were examined. Target volume coverage and doses to organs-at-risk (OARs) were calculated for each technique. Outcomes were compared with one-way analysis of variance and the Bonferroni test, with p-values <0.05 considered significant. Results: Target volume coverage was within acceptable levels in all interventions, except for the internal mammary lymph node D95 (99% in PBT, 90% in VMAT-CPAP, 84% in VMAT-FB, and 74% in 3DCRT). The mean heart dose (MHD) was the lowest in PBT (<1 Gy) and VMAT-CPAP (2.2 Gy) and the highest in 3DCRT with CF/FB (7.8 Gy), respectively. The mean lung dose (MLD) was the highest in 3DCRT-CF-FB (20 Gy) and the lowest in both VMAT-HF-CPAP and PBT (approximately 5-6 Gy). VMAT-HF-CPAP and PBT delivered a comparable maximum dose to the left ascending artery (7.2 and 6.13 Gy, respectively). Conclusions: Both proton and VMAT in combination with CPAP can minimize the radiation exposure to heart and lung with optimal target coverage in regional RT for left-sided breast cancer. The clinical relevance of these differences is yet to be elucidated. Continued efforts are needed to minimize radiation exposures during RT treatment to maximize its therapeutic index.
Files in This Item:
T202104031.pdf Download
DOI
10.3389/fonc.2021.645328
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Kim, Jinsung(김진성) ORCID logo https://orcid.org/0000-0003-1415-6471
Chang, Jee Suk(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
Han, Min Cheol(한민철)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/185098
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links