Dosimetric comparison of IMRT versus 3DCRT for post-mastectomy chest wall irradiation

Rastogi, Kartick; Sharma, Shantanu; Gupta, Shivani; Agarwal, Nikesh; Bhaskar, Sandeep; Jain, Sandeep

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자료유형: 학술저널

저자정보: Rastogi, Kartick (Department of Radiotherapy, Sawai Man Singh Medical College and Attached Group of Hospitals) Sharma, Shantanu (Department of Radiotherapy, Sawai Man Singh Medical College and Attached Group of Hospitals) Gupta, Shivani (Department of Radiotherapy, Sawai Man Singh Medical College and Attached Group of Hospitals) Agarwal, Nikesh (Department of Radiotherapy, Sawai Man Singh Medical College and Attached Group of Hospitals) Bhaskar, Sandeep (Department of Radiotherapy, Sawai Man Singh Medical College and Attached Group of Hospitals) Jain, Sandeep (Department of Radiotherapy, Sawai Man Singh Medical College and Attached Group of Hospitals)

저널정보: 대한방사선종양학회 Radiation oncology journal : ROJ Radiation oncology journal : ROJ 제36권 제1호

발행연도: 2018.1

수록면: 71 - 78 (8page)

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Purpose: To compare the dose distribution of three-dimensional conformal radiation therapy (3DCRT) with intensity-modulated radiation therapy (IMRT) for post-mastectomy radiotherapy (PMRT) to left chest wall. Materials and Methods: One hundred and seven patients were randomised for PMRT in 3DCRT group (n = 64) and IMRT group (n = 43). All patients received 50 Gy in 25 fractions. Planning target volume (PTV) parameters-$D_{near-max}$ ($D_2$), $D_{near-min}$ ($D_{98}$), $D_{mean}$, $V_{95}$, and $V_{107}$-homogeneity index (HI), and conformity index (CI) were compared. The mean doses of lung and heart, percentage volume of ipsilateral lung receiving 5 Gy ($V_5$), 20 Gy ($V_{20}$), and 55 Gy ($V_{55}$) and that of heart receiving 5 Gy ($V_5$), 25 Gy ($V_{25}$), and 45 Gy ($V_{45}$) were extracted from dose-volume histograms and compared. Results: PTV parameters were comparable between the two groups. CI was significantly improved with IMRT (1.127 vs. 1.254, p < 0.001) but HI was similar (0.094 vs. 0.096, p = 0.83) compared to 3DCRT. IMRT in comparison to 3DCRT significantly reduced the high-dose volumes of lung ($V_{20}$, 22.09% vs. 30.16%; $V_{55}$, 5.16% vs. 10.27%; p < 0.001) and heart ($V_{25}$, 4.59% vs. 9.19%; $V_{45}$, 1.85% vs. 7.09%; p < 0.001); mean dose of lung and heart (11.39 vs. 14.22 Gy and 4.57 vs. 8.96 Gy, respectively; p < 0.001) but not the low-dose volume ($V_5$ lung, 61.48% vs. 51.05%; $V_5$ heart, 31.02% vs. 23.27%; p < 0.001). Conclusions: For left sided breast cancer, IMRT significantly improves the conformity of plan and reduce the mean dose and high-dose volumes of ipsilateral lung and heart compared to 3DCRT, but 3DCRT is superior in terms of low-dose volume.

#Breast cancer #Intensity-modulated radiotherapy #Modified radical mastectomy #Radiation dosimetry #Three-dimensional conformal radiotherapy

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