title: Simultaneous-integrated boost intensity-modulated radiation therapy (SIB-IMRT) in the treatment of early-stage left-sided breast carcinoma.
abstract: We assessed the feasibility and impact of simultaneous-integrated boost intensity-modulated radiation therapy (SIB-IMRT) in the treatment of left breast carcinoma and compared target coverage and normal tissue doses with SIB-IMRT and 3-dimensional (3D) conformal RT using opposed tangential fields. For each of 10 patients with early-stage left-sided invasive breast carcinoma, 5 plans were generated; the first 4 were 3D conformal opposed tangential fields-2 with wedges, 2 with compensators and either photon or electron boost. A dose of 50.4 Gy in 28 fractions was prescribed to the left breast and an additional 16 Gy in 8 fractions to the lumpectomy bed. When compared to the tangential plans, SIB-IMRT maintained coverage (V(95%)) to the left breast and lumpectomy bed without significantly increasing the left breast maximum dose. SIB-IMRT was able to reduce the lung mean dose, maximum dose, and the V(20) by 55-104 cGy, 983-1298 cGy (p < 0.001), and 3.7-4.4%, respectively. In addition, SIB-IMRT reduced the maximum heart dose by 1032-1173 cGy and contralateral breast dose was increased (although p = NS). The mean and maximum dose to the unspecified tissues was also significantly reduced by 81-88 cGy and 516-942 cGy, respectively. SIB-IMRT resulted in a significant improvement in target dose conformality by up to 67%. Our findings that SIB-IMRT could improve dose conformality, reduce total treatment times, and reduce some of the normal structure doses presents it as an alternative technique for adjuvant breast radiotherapy; however this needs to be studied further in the clinic setting.
authors.affiliation: Department of Radiation Oncology, Loyola University Medical Center, Maywood, IL 60153, USA.
authors.forename: Rajanish
authors.initials: R
authors.lastname: Singla
authors.forename: Stephanie
authors.initials: S
authors.lastname: King
authors.forename: Kevin
authors.initials: K
authors.lastname: Albuquerque
authors.forename: Steve
authors.initials: S
authors.lastname: Creech
authors.forename: Nesrin
authors.initials: N
authors.lastname: Dogan
mesh_terms: D001943:Breast Neoplasms / Q000532:radiotherapy*; D004305:Dose-Response Relationship, Drug; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*