title: Predictive parameters for selection of electronic tissue compensation radiotherapy in early-stage breast cancer patients after breast-conserving surgery.
abstract: Electronic tissue compensation (eComp) is an external beam planning technique allowing user to manually generate dynamic beam fluence to produce more uniform or modulated dose distribution. In this study, we compared the effectiveness between conventional three-dimensional conformal radiotherapy (3DCRT) and eComp for whole breast irradiation. 3DCRT and eComp planning techniques were used to generate treatment plans for 60 whole breast patients, respectively. The planning goal was to cover 95% of the planning target volume (PTV) with 95% of the prescription dose while minimizing doses to lung, heart, and skin. Comparing to 3DCRT plans, on the average, eComp treatment planning process was about 7 minutes longer, but resulted in lower lung V20Gy, lower mean skin dose, with similar heart dose. The benefits were more pronounced for larger breast patients. Statistical analyses were performed between critical organ doses and patient anatomic features, i.e., central lung distance (CLD), maximal heart distance (MHD), maximal heart length (MHL) and breast separation (BS) to explore any correlations and planning method selection. It was found that to keep the lung V20Gy lower than 20% and mean skin dose lower than 85% of the prescription dose, eComp was the preferred method for patients with more than 2.3 cm CLD or larger than 22.5 cm BS. The study results may be useful in providing a handy criterion in clinical practice allowing us to easily choose between different planning techniques to satisfy the planning goal with minimal increase in complexity and cost.
authors.affiliation: Department of Radiation Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Yanbo
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, Rutgers The State University of New Jersey, New Brunswick, New Jersey, USA.
authors.forename: Miao
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Radiation Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Gan
authors.affiliation: Department of Radiation Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Xiaopin
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, Rutgers The State University of New Jersey, New Brunswick, New Jersey, USA.
authors.forename: Ning J
authors.initials: NJ
authors.lastname: Yue
authors.affiliation: Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, Rutgers The State University of New Jersey, New Brunswick, New Jersey, USA.
authors.forename: Sharad
authors.initials: S
authors.lastname: Goyal
authors.affiliation: Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, Rutgers The State University of New Jersey, New Brunswick, New Jersey, USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Haffty
authors.affiliation: Department of Radiation Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.|Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Guosheng
authors.initials: G
authors.lastname: Ren
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D002681:China; D005260:Female; D006321:Heart / Q000528:radiation effects; D006801:Humans; D008168:Lung / Q000528:radiation effects; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging; D000069079:Radiation Exposure; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D018714:Radiotherapy, Adjuvant; D020266:Radiotherapy, Conformal / Q000009:adverse effects; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D012867:Skin / Q000528:radiation effects; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D057188:Workflow
keywords: 3DCRT; anatomic parameter; breast cancer; electronic tissue compensation; radiotherapy