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KMID : 1188520150110020120
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Korean Journal of Clinical Oncology
2015 Volume.11 No. 2 p.120 ~ p.125
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Tangential beam intensity modulated radiotherapy versus tangential beam three-dimensional conformal radiotherapy in carcinoma breast: A dosimetric comparison and clinical correlation
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Phansopkar Deepti Arun
Sachdeva Jaineet
Mahajan Manmohan Krishan
Kingsley Pamela Alice
Upadhyay Shekhar
Chakravarti Rajesh
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Abstract
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Purpose: This study evaluates the dose distribution of tangential beam intensity modulated radiotherapy (IMRT) compared to tangential beam three-dimensional conformal radiotherapy (3D-CRT) in carcinoma breast.
Methods: Tangential beam IMRT and tangential beam 3D-CRT plans were generated in 54 postoperative breast cancer patients. Planning target volume (PTV) definition of chest wall and intact breast was done according to Breast Cancer Atlas for Radiation Therapy Oncology Group. The prescribed dose was 50 Gy in 25 fractions. Dose volume histograms was evaluated for PTV and organs at risk, parameters of the dose distribution were compared for 3D-CRT and IMRT using Wilcoxon Matched pairs test. The dosages were clinically correlated with normal tissue reactions.
Results: No difference in the conformity index but IMRT improves the homogeneity index significantly (P<0.01). The mean dose to all organs at risk was lesser in IMRT as compared to 3D-CRT of which the dose to contralateral lung was significantly lower with IMRT (111.7 cGy vs. 41.98 cGy, P=0.024). Tangential beam IMRT significantly reduces ipsilateral lung V20% by 24%. Heart V70% is decreased by V74% and V30% by V38% doses but not statistically significant.
Conclusion: Tangential beam IMRT in breast cancer offers the potential to significantly reduce the dose-volume of the ipsilateral lung and dose volume of the heart which will translate into decrease in risk of cardiac and lung toxicity and also decreased second cancer risk. IMRT definitely decreases the acute skin reactions in all patients.
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KEYWORD
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Breast cancer, Intensity modulated radiotherapy, Three-dimensional conformal radiotherapy, Dosimetric comparison
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