Limited benefit of inversely optimised intensity modulation in breast conserving radiotherapy with simultaneously integrated boost

Abstract Background and purpose To examine whether in breast-conserving radiotherapy (RT) with simultaneously integrated boost (SIB), application of inversely planned intensity-modulated radiotherapy (IMRT-SIB) instead of three-dimensional RT (3D-CRT-SIB) has benefits that justify the additional cos...

Full description

Saved in:
Bibliographic Details
Published in:Radiotherapy and oncology 2010-03, Vol.94 (3), p.307-312
Main Authors: van der Laan, Hans Paul, Dolsma, Wil V, Schilstra, Cornelis, Korevaar, Erik W, Bock, Geertruida H. de, Maduro, John H, Langendijk, Johannes A
Format: Article
Language:English
Subjects:
3D-CRT
Breast cancer
Breast Neoplasms - radiotherapy
Female
Hematology, Oncology and Palliative Medicine
Humans
IMRT
Mastectomy, Segmental
Normal tissue
Radiotherapy Dosage
Radiotherapy, Intensity-Modulated
Simultaneously integrated boost
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background and purpose To examine whether in breast-conserving radiotherapy (RT) with simultaneously integrated boost (SIB), application of inversely planned intensity-modulated radiotherapy (IMRT-SIB) instead of three-dimensional RT (3D-CRT-SIB) has benefits that justify the additional costs, and to evaluate whether a potential benefit of IMRT-SIB depends on specific patient characteristics. Material and methods 3D-CRT-SIB and various IMRT-SIB treatment plans were constructed and optimised for 30 patients with early stage left-sided breast cancer. Coverage of planning target volumes (PTVs) and dose delivered to organs at risk (OARs) were determined for each plan. Overlap between heart and breast PTV (OHB), size of breast and boost PTVs and boost location were examined in their ability to identify patients that might benefit from IMRT-SIB. Results All plans had adequate PTV coverage. IMRT-SIB generally reduced dose levels delivered to heart, lungs, and normal breast tissue relative to 3D-CRT-SIB. However, IMRT-SIB benefit differed per patient. For many patients, comparable results were obtained with 3D-CRT-SIB, while patients with OHB > 1.4 cm and a relatively large boost PTV volume (>125 cm3 ) gained most from the use of IMRT-SIB. Conclusions In breast-conserving RT, results obtained with 3D-CRT-SIB and IMRT-SIB are generally comparable. Patient characteristics could be used to identify patients that are most likely to benefit from IMRT-SIB.
ISSN:0167-8140
1879-0887
DOI:10.1016/j.radonc.2010.01.024