title: Three-dimensional conformal versus intensity modulated radiotherapy in breast cancer treatment: is necessary a medical reversal?
abstract: OBJECTIVE
  Aim of the present study is to compare three-dimensional conformal RT (3D-CRT) and 4-fields intensity modulated radiation therapy (4f-IMRT) treatment plans, in terms of target dose coverage, integral dose and dose to Organs at risk (OARs) in early breast cancer (BC).
  
  
  METHODS
  Twenty consecutive BC patients, after lumpectomy, were selected for the present analysis. A total dose of 50 Gy and a simultaneous dose of 60 Gy in 25 fractions was prescribed to Planning Target Volume of the whole breast (PTVbreast) and of the surgical bed, respectively. For each patient, a 3D-CRT plan and a sliding-window 4f-IMRT plan were generated. Conformity and homogeneity indexes (CI, HI) and various organ specific VxGyvalues were analyzed for PTVs, OARs and normal tissue (NT), respectively.
  
  
  RESULTS
  In terms of HI, 4f-IMRT was superior to 3D-CRT for the PTVbreast(p < 0.0001), and a significant difference for CI was observed in favor of 4f-IMRT (p < 0.0001).In terms of dose to OARs, a superiority of 4f-IMRT was shown. For NT, all parameters are in favor of IMRT, except the V5Gyfor which the difference was not statistically significant. The average NT-Dmeanwas 2.7 ± 0.7 for 3D-CRT and 1.8 ± 0.5 for 4f-IMRT (p < 0.0001).
  
  
  CONCLUSIONS
  4f-IMRT technique significantly reduced the dose to OARs and NT, with a better target coverage compared to 3D-CRT.
authors: Radiation Oncology Division, Radiation Oncology Department, Sacro Cuore Don Calabria Hospital, Cancer Care Center, Via Don Sempeboni 5, 37034, Negrar-Verona, Italy. alba.fiorentino@sacrocuore.it.
authors: Alba
authors: A
authors: Fiorentino
authors: Radiation Oncology Division, Radiation Oncology Department, Sacro Cuore Don Calabria Hospital, Cancer Care Center, Via Don Sempeboni 5, 37034, Negrar-Verona, Italy.
authors: Ruggero
authors: R
authors: Ruggieri
authors: Radiation Oncology Division, Radiation Oncology Department, Sacro Cuore Don Calabria Hospital, Cancer Care Center, Via Don Sempeboni 5, 37034, Negrar-Verona, Italy.
authors: Niccolò
authors: N
authors: Giaj-Levra
authors: Radiation Oncology Division, Radiation Oncology Department, Sacro Cuore Don Calabria Hospital, Cancer Care Center, Via Don Sempeboni 5, 37034, Negrar-Verona, Italy.
authors: Gianluisa
authors: G
authors: Sicignano
authors: Statistic Science Faculty, University of Palermo, Palermo, Italy.
authors: Gioacchino
authors: G
authors: Di Paola
authors: Radiation Oncology Division, Radiation Oncology Department, Sacro Cuore Don Calabria Hospital, Cancer Care Center, Via Don Sempeboni 5, 37034, Negrar-Verona, Italy.
authors: Stefania
authors: S
authors: Naccarato
authors: Radiation Oncology Division, Radiation Oncology Department, Sacro Cuore Don Calabria Hospital, Cancer Care Center, Via Don Sempeboni 5, 37034, Negrar-Verona, Italy.
authors: Sergio
authors: S
authors: Fersino
authors: Radiation Oncology Division, Radiation Oncology Department, Sacro Cuore Don Calabria Hospital, Cancer Care Center, Via Don Sempeboni 5, 37034, Negrar-Verona, Italy.
authors: Rosario
authors: R
authors: Mazzola
authors: Radiation Oncology Division, Radiation Oncology Department, Sacro Cuore Don Calabria Hospital, Cancer Care Center, Via Don Sempeboni 5, 37034, Negrar-Verona, Italy.|Radiation Oncology Division, University of Padua, Padua, Italy.
authors: Umberto
authors: U
authors: Tebano
authors: Radiation Oncology Division, Radiation Oncology Department, Sacro Cuore Don Calabria Hospital, Cancer Care Center, Via Don Sempeboni 5, 37034, Negrar-Verona, Italy.
authors: Francesco
authors: F
authors: Ricchetti
authors: Radiation Oncology Division, Radiation Oncology Department, Sacro Cuore Don Calabria Hospital, Cancer Care Center, Via Don Sempeboni 5, 37034, Negrar-Verona, Italy.
authors: Filippo
authors: F
authors: Alongi
mesh_terms: D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000379:methods; D020266:Radiotherapy, Conformal / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D016896:Treatment Outcome
keywords: Breast cancer; Conformal radiotherapy; Intensity modulated radiotherapy; Organs at risk