Potential gains: Comparison of a mono‐isocentric three‐dimensional conformal radiotherapy (3D‐CRT) planning technique to hybrid intensity‐modulated radiotherapy (hIMRT) to the whole breast and supraclavicular fossa (SCF) region
Abstract Introduction Until late 2018, standard of practice at the Northern Sydney Cancer Centre (NSCC) for breast and nodal treatment was a conformal mono‐isocentric technique. A planning study comparing an existing mono‐isocentric three‐dimensional conformal radiotherapy (3D‐CRT) planning techniqu...
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Wiley
2022-03-01
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Series: | Journal of Medical Radiation Sciences |
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Online Access: | https://doi.org/10.1002/jmrs.473 |
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author | Leigh Ambrose Cameron Stanton Lorraine Lewis Gillian Lamoury Marita Morgia Susan Carroll Regina Bromley John Atyeo |
author_facet | Leigh Ambrose Cameron Stanton Lorraine Lewis Gillian Lamoury Marita Morgia Susan Carroll Regina Bromley John Atyeo |
author_sort | Leigh Ambrose |
collection | DOAJ |
description | Abstract Introduction Until late 2018, standard of practice at the Northern Sydney Cancer Centre (NSCC) for breast and nodal treatment was a conformal mono‐isocentric technique. A planning study comparing an existing mono‐isocentric three‐dimensional conformal radiotherapy (3D‐CRT) planning technique to a hybrid intensity‐modulated radiotherapy (hIMRT) approach for the whole breast and supraclavicular fossa (SCF) region was undertaken with the aim to improve plan quality by improving dose conformity/homogeneity across target volumes and reducing hotspots outside the target. Methods A cohort of 17 patients was retrospectively planned using the proposed hIMRT technique, keeping the same planning constraints as the original treated breast and SCF 3D‐CRT plan and normalising the 3D‐CRT plans to achieve minimum breast/SCF target coverage to compare organs at risk (OARs). Normal tissue index (NTI) and homogeneity index (HI) were compared for plan quality as well as for evaluating OARs. Results The hIMRT technique showed statistically significant improvements in NTI and HI, as well as improvement in maximum brachial plexus and thyroid doses. There was a negligible increase in maximum oesophagus dose which could be improved if used in optimisation. Other OAR doses in the irradiated region were comparable to the 3D‐CRT plans, however maximum doses were reduced overall. Conclusion The hIMRT planning technique maintained clinically acceptable doses to OARs and reduced normal tissue dose while maintaining equivalent dose coverage to breast and SCF planning target volumes with improved conformity and homogeneity. The reduction in maximum doses promotes a favourable toxicity profile, with potential benefit of improved long‐term cosmesis. |
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issn | 2051-3895 2051-3909 |
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spelling | doaj.art-c6dfea1b2b744704956892cccfade0f32022-12-21T16:43:14ZengWileyJournal of Medical Radiation Sciences2051-38952051-39092022-03-01691758410.1002/jmrs.473Potential gains: Comparison of a mono‐isocentric three‐dimensional conformal radiotherapy (3D‐CRT) planning technique to hybrid intensity‐modulated radiotherapy (hIMRT) to the whole breast and supraclavicular fossa (SCF) regionLeigh Ambrose0Cameron Stanton1Lorraine Lewis2Gillian Lamoury3Marita Morgia4Susan Carroll5Regina Bromley6John Atyeo7Department of Radiation Oncology Northern Sydney Cancer Centre Royal North Shore Hospital St Leonards NSW AustraliaDepartment of Radiation Oncology Northern Sydney Cancer Centre Royal North Shore Hospital St Leonards NSW AustraliaDepartment of Radiation Oncology Northern Sydney Cancer Centre Royal North Shore Hospital St Leonards NSW AustraliaDepartment of Radiation Oncology Northern Sydney Cancer Centre Royal North Shore Hospital St Leonards NSW AustraliaDepartment of Radiation Oncology Northern Sydney Cancer Centre Royal North Shore Hospital St Leonards NSW AustraliaDepartment of Radiation Oncology Northern Sydney Cancer Centre Royal North Shore Hospital St Leonards NSW AustraliaDepartment of Radiation Oncology Northern Sydney Cancer Centre Royal North Shore Hospital St Leonards NSW AustraliaDepartment of Radiation Oncology Northern Sydney Cancer Centre Royal North Shore Hospital St Leonards NSW AustraliaAbstract Introduction Until late 2018, standard of practice at the Northern Sydney Cancer Centre (NSCC) for breast and nodal treatment was a conformal mono‐isocentric technique. A planning study comparing an existing mono‐isocentric three‐dimensional conformal radiotherapy (3D‐CRT) planning technique to a hybrid intensity‐modulated radiotherapy (hIMRT) approach for the whole breast and supraclavicular fossa (SCF) region was undertaken with the aim to improve plan quality by improving dose conformity/homogeneity across target volumes and reducing hotspots outside the target. Methods A cohort of 17 patients was retrospectively planned using the proposed hIMRT technique, keeping the same planning constraints as the original treated breast and SCF 3D‐CRT plan and normalising the 3D‐CRT plans to achieve minimum breast/SCF target coverage to compare organs at risk (OARs). Normal tissue index (NTI) and homogeneity index (HI) were compared for plan quality as well as for evaluating OARs. Results The hIMRT technique showed statistically significant improvements in NTI and HI, as well as improvement in maximum brachial plexus and thyroid doses. There was a negligible increase in maximum oesophagus dose which could be improved if used in optimisation. Other OAR doses in the irradiated region were comparable to the 3D‐CRT plans, however maximum doses were reduced overall. Conclusion The hIMRT planning technique maintained clinically acceptable doses to OARs and reduced normal tissue dose while maintaining equivalent dose coverage to breast and SCF planning target volumes with improved conformity and homogeneity. The reduction in maximum doses promotes a favourable toxicity profile, with potential benefit of improved long‐term cosmesis.https://doi.org/10.1002/jmrs.473Breast radiotherapyconformal radiotherapyintensity‐modulated radiotherapyorgans at riskplanning techniques |
spellingShingle | Leigh Ambrose Cameron Stanton Lorraine Lewis Gillian Lamoury Marita Morgia Susan Carroll Regina Bromley John Atyeo Potential gains: Comparison of a mono‐isocentric three‐dimensional conformal radiotherapy (3D‐CRT) planning technique to hybrid intensity‐modulated radiotherapy (hIMRT) to the whole breast and supraclavicular fossa (SCF) region Journal of Medical Radiation Sciences Breast radiotherapy conformal radiotherapy intensity‐modulated radiotherapy organs at risk planning techniques |
title | Potential gains: Comparison of a mono‐isocentric three‐dimensional conformal radiotherapy (3D‐CRT) planning technique to hybrid intensity‐modulated radiotherapy (hIMRT) to the whole breast and supraclavicular fossa (SCF) region |
title_full | Potential gains: Comparison of a mono‐isocentric three‐dimensional conformal radiotherapy (3D‐CRT) planning technique to hybrid intensity‐modulated radiotherapy (hIMRT) to the whole breast and supraclavicular fossa (SCF) region |
title_fullStr | Potential gains: Comparison of a mono‐isocentric three‐dimensional conformal radiotherapy (3D‐CRT) planning technique to hybrid intensity‐modulated radiotherapy (hIMRT) to the whole breast and supraclavicular fossa (SCF) region |
title_full_unstemmed | Potential gains: Comparison of a mono‐isocentric three‐dimensional conformal radiotherapy (3D‐CRT) planning technique to hybrid intensity‐modulated radiotherapy (hIMRT) to the whole breast and supraclavicular fossa (SCF) region |
title_short | Potential gains: Comparison of a mono‐isocentric three‐dimensional conformal radiotherapy (3D‐CRT) planning technique to hybrid intensity‐modulated radiotherapy (hIMRT) to the whole breast and supraclavicular fossa (SCF) region |
title_sort | potential gains comparison of a mono isocentric three dimensional conformal radiotherapy 3d crt planning technique to hybrid intensity modulated radiotherapy himrt to the whole breast and supraclavicular fossa scf region |
topic | Breast radiotherapy conformal radiotherapy intensity‐modulated radiotherapy organs at risk planning techniques |
url | https://doi.org/10.1002/jmrs.473 |
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