학술논문

New fractionations in breast cancer: a dosimetric study of 3D‐CRT versus VMAT
Document Type
article
Source
Journal of Medical Radiation Sciences, Vol 69, Iss 2, Pp 227-235 (2022)
Subject
early breast cancer
hypofractionated treatment
radiotherapy
three‐dimensional conformal radiation therapy
volumetric modulated arc therapy
Medical physics. Medical radiology. Nuclear medicine
R895-920
Language
English
ISSN
2051-3909
2051-3895
Abstract
Abstract Introduction Adjuvant radiation therapy (RT) following primary surgery in women affected by early breast cancer (EBC) plays a central role in reducing local recurrences and overall mortality. The FAST‐FORWARD trial recently demonstrated that 1‐week hypofractionated adjuvant RT is not inferior to the standard schedule in terms of local relapse, cosmetic outcomes and toxicity. The aim of this in silico study was to evaluate the dosimetric aspects of a 1‐week RT course, administered through volumetric modulated arc therapy (VMAT), compared with traditional three‐dimensional conformal radiation therapy (3D‐CRT) with tangential fields. Methods Patients affected by left‐side EBC undergoing adjuvant RT were selected. ESTRO guidelines for the clinical target volume (CTV) delineation and FAST‐FORWARD protocol for CTV to planning target volume (PTV) margin definition were followed. Total prescribed dose was 26 Gy in five fractions. The homogeneity index (HI) and the global conformity index (GCI) were taken into account for planning and dose distribution optimisation purposes. Both 3D‐CRT tangential fields and VMAT plans were generated for each patient. Results The analysis included 21 patients. PTV coverage comparison between 3D‐CRT and VMAT plans showed significant increases for GCI (P