Evaluation of two tomotherapy-based techniques for the delivery of whole-breast intensity-modulated radiation therapy.
OBJECTIVE
To evaluate two different techniques for whole-breast treatments delivered using the Hi-ART II tomotherapy device.


METHODS
Tomotherapy uses the standard rotational helical delivery. Topotherapy uses a stationary gantry while delivering intensity-modulated treatments. CT scans from 5 breast cancer patients were used. The prescription dose was 50.4 Gy.


RESULTS
On average, 99% of the target volume received 95% of prescribed dose with either technique. If treatment times are restricted to less than 9 min, the average percentage ipsilateral lung receiving > or =20 Gy was 22% for tomotherapy vs. 10% for topotherapy. The ipsilateral lung receiving > or =50.4 Gy was 4 cc for tomotherapy vs. 27 cc for topotherapy. The percentage of left ventricle receiving > or =30 Gy was 14% with tomotherapy vs. 4% for topotherapy. The average doses to the contralateral breast and lung were 0.6 and 0.8 Gy, respectively, for tomotherapy vs. 0.4 and 0.3 Gy for topotherapy.


CONCLUSIONS
Tomotherapy provides improved target dose homogeneity and conformality over topotherapy. If delivery times are restricted, topotherapy reduces the amount of heart and ipsilateral lung volumes receiving low doses. For whole-breast treatments, topotherapy is an efficient technique that achieves adequate target uniformity while maintaining low doses to sensitive structures.
Gonzalez
Victor J
VJ
Florida State University College of Medicine, Tallahassee, FL, USA.
Buchholz
Daniel J
DJ
Langen
Katja M
KM
Olivera
Gustavo H
GH
Chauhan
Bhavin
B
Meeks
Sanford L
SL
Ruchala
Kenneth J
KJ
Haimerl
Jason
J
Lu
Weiguo
W
Kupelian
Patrick A
PA
D001940:Breast / Q000528:radiation effects; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008168:Lung / Q000528:radiation effects; D011832:Radiation Injuries / Q000517:prevention & control; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D013997:Time Factors; D036542:Tomography, Spiral Computed / Q000379:methods