TITLE:
Radiotherapy to the Left Breast with 3DCRT, IMRT or VMAT: International Medical Center Experience
AUTHORS:
Hany S. Attallah, Radwa M. Hamed, Haytham A. Abdelkader, Mahmoud M. Abdallah, Aliaa Mahmoud, Ibraheem Haggag, Bassam E. Makram, Ahmed M. El-Saeed
KEYWORDS:
Left Breast Radiotherapy, 3DCRT, IMRT, VMAT, Large Breast, Nodal Irradiation, Boost
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.12 No.3,
March
10,
2021
ABSTRACT: Radiation therapy after conservative breast surgery is an integral part
of the treatment of early breast cancer. The aim of radiotherapy is to achieve the best coverage of the Planning Target
Volume (PTV), while reducing the dose to
the Organs at Risk (OAR). Such goals are not always achievable with the
conformal three dimensions plans (3DCRT). Recently, radiation oncologist uses Intensity Modulated Radiotherapy (IMRT)
and Volumetric Modulated Arc Therapy (VMAT) for
irradiating the breast. In this study, we compared 3DCRT, IMRT and VMAT for left breast cancer patients in
terms of PTV coverage, OAR. We also revised the different dose distribution in 1)
different breast volume categories, 2) nodal irradiation versus breast only,
and 3) boost versus no boost. Results: The routinely reported dose constrains for the ipsilateral lung and for the heart were not significantly different on comparing the
three techniques. While for the contralateral lung, the difference in mean dose
was in favor of 3DCRT. In large breast volume, 3DCRT provided a lower Max dose to the contralateral lung and the lowest mean dose to the
contralateral breast when compared to IMRT p . In case of no
nodal irradiation, the contralateral breast mean dose was lower in 3DCRT in comparison to IMRT and VMAT p : The three techniques (3DCRT, IMRT, and VMAT) can meet
the clinical dosimetry demands of radiotherapy for left breast cancer after
conservative surgery, as long as the routinely OARs only (heart and ipsilateral
lung) are reported. Our study showed that 3CDRT can provide a lower dose to the
contralateral organs (breast and lung), specially,
in case of large breast volumes, no nodal irradiation and when a boost is given.