A dose planning study for cardiac and lung dose sparing techniques in left breast cancer radiotherapy: Can free breathing helical tomotherapy be considered as an alternative for deep inspiration breath hold?
Purpose: To investigate the possibility to be able to offer left sided breast cancer patients, not suitable for DIBH, an organ at risk saving treatment. Materials and Methods: Twenty patients receiving radiotherapy for left breast cancer in DIBH were enrolled in the study. Planning CT scans were acq...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-03-01
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| Series: | Technical Innovations & Patient Support in Radiation Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S240563242300001X |
| _version_ | 1797884484462313472 |
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| author | Sara Abdollahi Mohammad Hadi Hadizadeh Yazdi Ali Asghar Mowlavi Sofie Ceberg Marianne Camille Aznar Fatemeh Varshoee Tabrizi Roham Salek Alireza Ghodsi Ali Shams |
| author_facet | Sara Abdollahi Mohammad Hadi Hadizadeh Yazdi Ali Asghar Mowlavi Sofie Ceberg Marianne Camille Aznar Fatemeh Varshoee Tabrizi Roham Salek Alireza Ghodsi Ali Shams |
| author_sort | Sara Abdollahi |
| collection | DOAJ |
| description | Purpose: To investigate the possibility to be able to offer left sided breast cancer patients, not suitable for DIBH, an organ at risk saving treatment. Materials and Methods: Twenty patients receiving radiotherapy for left breast cancer in DIBH were enrolled in the study. Planning CT scans were acquired in the same supine treatment position in FB and DIBH. 3DCRT_DIBH plans were designed and optimized using two parallel opposed tangent beams (with some additional segments) for the breast and chest wall and anterior-posterior fields for regional lymph nodes irradiation. Additionally, FB helical tomotherapy plans were optimized to minimize heart and lung dose. All forty plans were optimized with at least 95% of the total CTV covered by the 95% of prescribed dose of 50 Gy in 25 fractions. Results: HT_FB plans showed significantly better dose homogeneity and conformity compared to the 3DCRT_DIBH specially for regional nodal irradiation. The heart mean dose was almost comparable in 3DCRT_DIBH and HT_FB while the volume (%) of the heart receiving 25 Gy had a statistically significant reduction from 7.90 ± 3.33 in 3DCRT_DIBH to 0.88 ± 0.66 in HT_FB. HT_FB was also more effective in left descending artery (LAD) mean dose reduction about 100% from 30.83 ± 9.2 Gy to 9.7 ± 3.1. The ipsilateral lung volume receiving 20 Gy has a further reduction of 43 % in HT_FB compared with 3DCRT_DIBH. For low dose comparison, 3DCRT_DIBH was superior for contralateral organ sparing compared to the HT_FB due to the limited angle for dose delivery. Conclusion: For patients who cannot be a candidate for DIBH for any reason, HT in free breathing may be a good alternative and provides heart and ipsilateral lung dose sparing, however with the cost of increased dose to contralateral breast and lung. |
| first_indexed | 2024-04-10T04:08:27Z |
| format | Article |
| id | doaj.art-8406f0acd91e4c7b9af42646fa25da38 |
| institution | Directory Open Access Journal |
| issn | 2405-6324 |
| language | English |
| last_indexed | 2024-04-10T04:08:27Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Technical Innovations & Patient Support in Radiation Oncology |
| spelling | doaj.art-8406f0acd91e4c7b9af42646fa25da382023-03-13T04:15:40ZengElsevierTechnical Innovations & Patient Support in Radiation Oncology2405-63242023-03-0125100201A dose planning study for cardiac and lung dose sparing techniques in left breast cancer radiotherapy: Can free breathing helical tomotherapy be considered as an alternative for deep inspiration breath hold?Sara Abdollahi0Mohammad Hadi Hadizadeh Yazdi1Ali Asghar Mowlavi2Sofie Ceberg3Marianne Camille Aznar4Fatemeh Varshoee Tabrizi5Roham Salek6Alireza Ghodsi7Ali Shams8Physics Department, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran; Medical Physics Department, Reza Radiotherapy and Oncology Center, Mashhad, IranPhysics Department, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, IranPhysics Department, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran; Corresponding author at: Physics Department, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, IranMedical Radiation Physics, Lund University, Lund, SwedenDivision of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United KingdomRadiotherapy and Oncology Department, Reza Radiotherapy and Oncology Center, Mashhad, IranRadiotherapy and Oncology Department, Reza Radiotherapy and Oncology Center, Mashhad, Iran; Radiotherapy and Oncology Department, Mashhad University of Medical Science, Mashhad, IranDepartment of Statistics, Hakim Sabzevari University, Sabzevar, IranMedical Physics Department, Seyed-al-Shohada Hospital, Isfahan, IranPurpose: To investigate the possibility to be able to offer left sided breast cancer patients, not suitable for DIBH, an organ at risk saving treatment. Materials and Methods: Twenty patients receiving radiotherapy for left breast cancer in DIBH were enrolled in the study. Planning CT scans were acquired in the same supine treatment position in FB and DIBH. 3DCRT_DIBH plans were designed and optimized using two parallel opposed tangent beams (with some additional segments) for the breast and chest wall and anterior-posterior fields for regional lymph nodes irradiation. Additionally, FB helical tomotherapy plans were optimized to minimize heart and lung dose. All forty plans were optimized with at least 95% of the total CTV covered by the 95% of prescribed dose of 50 Gy in 25 fractions. Results: HT_FB plans showed significantly better dose homogeneity and conformity compared to the 3DCRT_DIBH specially for regional nodal irradiation. The heart mean dose was almost comparable in 3DCRT_DIBH and HT_FB while the volume (%) of the heart receiving 25 Gy had a statistically significant reduction from 7.90 ± 3.33 in 3DCRT_DIBH to 0.88 ± 0.66 in HT_FB. HT_FB was also more effective in left descending artery (LAD) mean dose reduction about 100% from 30.83 ± 9.2 Gy to 9.7 ± 3.1. The ipsilateral lung volume receiving 20 Gy has a further reduction of 43 % in HT_FB compared with 3DCRT_DIBH. For low dose comparison, 3DCRT_DIBH was superior for contralateral organ sparing compared to the HT_FB due to the limited angle for dose delivery. Conclusion: For patients who cannot be a candidate for DIBH for any reason, HT in free breathing may be a good alternative and provides heart and ipsilateral lung dose sparing, however with the cost of increased dose to contralateral breast and lung.http://www.sciencedirect.com/science/article/pii/S240563242300001XLeft breast radiotherapyDeep inspiration breath-holdHelical TomotherapyToxicity management |
| spellingShingle | Sara Abdollahi Mohammad Hadi Hadizadeh Yazdi Ali Asghar Mowlavi Sofie Ceberg Marianne Camille Aznar Fatemeh Varshoee Tabrizi Roham Salek Alireza Ghodsi Ali Shams A dose planning study for cardiac and lung dose sparing techniques in left breast cancer radiotherapy: Can free breathing helical tomotherapy be considered as an alternative for deep inspiration breath hold? Technical Innovations & Patient Support in Radiation Oncology Left breast radiotherapy Deep inspiration breath-hold Helical Tomotherapy Toxicity management |
| title | A dose planning study for cardiac and lung dose sparing techniques in left breast cancer radiotherapy: Can free breathing helical tomotherapy be considered as an alternative for deep inspiration breath hold? |
| title_full | A dose planning study for cardiac and lung dose sparing techniques in left breast cancer radiotherapy: Can free breathing helical tomotherapy be considered as an alternative for deep inspiration breath hold? |
| title_fullStr | A dose planning study for cardiac and lung dose sparing techniques in left breast cancer radiotherapy: Can free breathing helical tomotherapy be considered as an alternative for deep inspiration breath hold? |
| title_full_unstemmed | A dose planning study for cardiac and lung dose sparing techniques in left breast cancer radiotherapy: Can free breathing helical tomotherapy be considered as an alternative for deep inspiration breath hold? |
| title_short | A dose planning study for cardiac and lung dose sparing techniques in left breast cancer radiotherapy: Can free breathing helical tomotherapy be considered as an alternative for deep inspiration breath hold? |
| title_sort | dose planning study for cardiac and lung dose sparing techniques in left breast cancer radiotherapy can free breathing helical tomotherapy be considered as an alternative for deep inspiration breath hold |
| topic | Left breast radiotherapy Deep inspiration breath-hold Helical Tomotherapy Toxicity management |
| url | http://www.sciencedirect.com/science/article/pii/S240563242300001X |
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