title: Postoperative radiotherapy following mastectomy for patients with left-sided breast cancer: A comparative dosimetric study.
abstract: The purposes of this article were to compare the biophysical dosimetry for postmastectomy left-sided breast cancer using 4 different radiotherapy (RT) techniques. In total, 30 patients with left-sided breast cancer were randomly selected for this treatment planning study. They were planned using 4 RT techniques, including the following: (1) 3-dimensional conventional tangential fields (TFs), (2) tangential intensity-modulated therapy (T-IMRT), (3) 4 fields IMRT (4F-IMRT), and (4) single arc volumetric-modulated arc therapy (S-VMAT). The planning target volume (PTV) dose was prescribed 50Gy, the comparison of target dose distribution, conformity index, homogeneity index, dose to organs at risk (OARs), tumor control probability (TCP), normal tissue complication probability (NTCP), and number of monitor units (MUs) between 4 plans were investigated for their biophysical dosimetric difference. The target conformity and homogeneity of S-VMAT were better than the other 3 kinds of plans, but increased the volume of OARs receiving low dose (V5). TCP of PTV and NTCP of the left lung showed no statistically significant difference in 4 plans. 4F-IMRT plan was superior in terms of target coverage and protection of OARs and demonstrated significant advantages in decreasing the NTCP of heart by 0.07, 0.03, and 0.05 compared with TFs, T-IMRT, and S-VMAT plan. Compared with other 3 plans, TFs reduced the average number of MUs. Of the 4 techniques studied, this analysis supports 4F-IMRT as the most appropriate balance of target coverage and normal tissue sparing.
authors.affiliation: Department of Radiation Oncology, Hangzhou Cancer Hospital, Hangzhou, China. Electronic address: mashenglin@medmail.com.cn.
authors.forename: Jiahao
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, Hangzhou First People׳s Hospital, Hangzhou, China.
authors.forename: Xiadong
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Radiation Oncology, Hangzhou First People׳s Hospital, Hangzhou, China.
authors.forename: Qinghua
authors.initials: Q
authors.lastname: Deng
authors.affiliation: Department of Radiation Oncology, Hangzhou Cancer Hospital, Hangzhou, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Xia
authors.affiliation: Department of Radiation Oncology, Hangzhou Cancer Hospital, Hangzhou, China.
authors.forename: Shixiu
authors.initials: S
authors.lastname: Wu
authors.affiliation: Department of Breast Surgery, Hangzhou First People's Hospital, Hangzhou, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Radiation Oncology, Hangzhou First People׳s Hospital, Hangzhou, China.
authors.forename: Shenglin
authors.initials: S
authors.lastname: Ma
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D018365:Neoplasm, Residual; D011182:Postoperative Care / Q000379:methods; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D018714:Radiotherapy, Adjuvant / Q000379:methods; D020266:Radiotherapy, Conformal / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012984:Software; D012986:Software Validation; D016896:Treatment Outcome; D000069584:Unilateral Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery*
keywords: Breast cancer; Normal tissue sparing; Postmastectomy radiotherapy; Target coverage