title: Hypofractionated breast cancer radiotherapy. Helical tomotherapy in supine position or classic 3D-conformal radiotherapy in prone position: which is better?
abstract: We propose a comparative dosimetric study of whole-breast hypofractionated radiation therapy using helical tomotherapy (HT) in supine position and 3-D conformal radiotherapy (3D-CRT) in prone position. Twelve patients undergoing breast-conserving therapy were retrospectively selected from October to December 2012. Specific dose-volume parameters were selected for the study. The target coverage was adequate in all patients for both techniques. Significant differences in lung dose distribution were observed: maximum dose (mean value over the 12 plans) was 23.41 Gy in HT plans and 6.65 Gy in 3D-CRT; V20 (i.e. the lung volume receiving 20 Gy) was 0.31% in HT plans and 0.0% in 3D-CRT plans. The mean dose to the heart was 5.57 Gy and 0.93 Gy, respectively. The differences between the two techniques were significant (p<0.05) only for some parameters. We noted better results in the prone position, but with HT, dose constraints were mentioned for the whole set of considered organs.
authors.affiliation: National Cancer Institute, "Pascale" Foundation, Medical Physics Department, Via Mariano Semmola 1, 80100 Naples, Italy. f.cammarota@istitutotumori.na.it.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Cammarota
authors.forename: Francesca Maria
authors.initials: FM
authors.lastname: Giugliano
authors.forename: Luciano
authors.initials: L
authors.lastname: Iadanza
authors.forename: Luisa
authors.initials: L
authors.lastname: Cutillo
authors.forename: Matteo
authors.initials: M
authors.lastname: Muto
authors.forename: Diego
authors.initials: D
authors.lastname: Toledo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ravo
authors.forename: Sara
authors.initials: S
authors.lastname: Falivene
authors.forename: Paolo
authors.initials: P
authors.lastname: Muto
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D058958:Organs at Risk; D011379:Prognosis; D016684:Prone Position; D011874:Radiometry; D011880:Radiotherapy Planning, Computer-Assisted; D020266:Radiotherapy, Conformal; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D016683:Supine Position
keywords: 3D conformal radiation therapy; Hypofractionated radiation therapy; helical tomotherapy; prone treatment position; supine treatment position