Journal List > Prog Med Phys > v.24(4) > 1098402

TOOLS
Kim, Youn, and Kim: A Dosimetric Comparision of IMRT and VMAT in Synchronous Bilateral Breast Cancer
Original Article

Progress in Medical Physics 2013;24(4):284-289.

Published online: 17 December 2013

DOI: https://doi.org/10.14316/pmp.2013.24.4.284

A Dosimetric Comparision of IMRT and VMAT in Synchronous Bilateral Breast Cancer

Sung-Jin Kim∗, †, Seon-Min Youn∗, Sung Kyu Kim‡

∗Department of Radiation Oncology, Eulji University Hospital, Daejeon, Korea

†Department of Physics, Yeungnam University, Daegu, Korea

‡Department of Radiation Oncology, College of Medicine, Yeungnam University, Daegu, Korea

Copyright © 2013 Korean Society of Medical Physics

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A study was performed comparing dosimetric characteristics of volumetric modulated arc and intensity modulated radiatio therapy on patients with bilateral breast cancer. For 5 patients, 3 plans were made for each patient; IMRT beams 8 and 12 of the beam intensity modulated radiation therapy, volumetric modulated arc therapy plan. The average PTVs volumes and D98 for 12-IMRT were 51.04±0.57 Gy (right), 50.80±1.07 Gy (left), 42.94±16.16 Gy (right), 42.56±2.09 Gy (left). HI (D5∼D95) and CI90,95, even 12-IMRT has shown excellent results. In OAR, 3 plans showed excellent results. But the lowest dose of 12-IMRT. 12-IMRT achieved similar PTV coverage and sparing of organs at risk than 8-IMRT and VMAT

Keywords: Bilateral breast cancer, IMRT, VMAT

REFERENCES

1. Fisher B, Anderson S, Redmond CK, et al. Reanalysis and results after 12 years of followup in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med. 333(22):1456–1461. 1995.
crossref
2. Fogliataa A, Nicolinia G, Alberb M, et al. IMRT for breast. A planning study. Radiother Oncol. 76(3):300–310. 2005.
3. Nicolini G, Clivio A, Fogliata A, et al. Simultaneous integrated boost radiotherapy for bilateral breast: a treatment planning and dosimetric comparison for volumetric modulated arc and fixed field intensity modulated therapy. Rad Oncol. 4(1):27. 2009.
crossref
4. Intensity Modulated Radiation Therapy Collaborative Working Group. Intensity modulated radiotherapy: current status and issues of interest. Int J Radiation Oncology Biol Phys. 51(4):880–917. 2001.
5. Otto K. Volumetric modulated arc therapy: IMRT in a single gantry arc. Med Phys. 35(1):310–317. 2008.
crossref
6. Semenenko VA, Reitzet B, et al. Evaluation of a commercial biologically based IMRT treatment planning system. Med Phys. 35(12):5851–5860. 2008.
crossref
7. Lafond C, Gassa F, Odin C, et al. Comparison between two treatment planning systems for volumetric modulated arc therapy optimization for prostate cancer. Eur J Med Phys. 30(1):1–8. 2013.
crossref
8. Martha MM, Di Y, Inga G, Alvaro M. Clinical applications of volumetric modulated arc therapy. Int J Radiation Oncology Biol Phys. 77(2):608–616. 2010.
9. Clivio A, Fogliata A, Franzetti-Pellanda A, et al. Volumetricmodulated arc radiotherapy for carcinomas of the anal canal: A treatment planning comparison with fixed field IMRT. Radiother Oncol. 92(1):118–124. 2009.
crossref
10. Verbakel WF, Cuijpers JP, Hoffmans D, et al. Volumetric intensity-modulated arc therapy vs. conventional IMRT in headandneck cancer: a comparative planning and dosimetric study. Int J Radiat Oncol Biol Phys. 74(1):252–259. 2009.
crossref

Fig. 1.
The image shows Target definition on axis slice of the CT data set in the study. Blue: Light-blue contour, Planning Target Volume (PTV), Red: Light-red contour, Clinical Target Volume (CTV).
pmp-24-284f1.tif
Fig. 2.
The graph shows the (a) D5∼D95 (HI) (b) CI90, CI95 of total PTV.
pmp-24-284f2.tif
Fig. 3.
The graph shows the V90, V95, V105, V110 for (a) right side and (b) left side % volume of PTV.
pmp-24-284f3.tif
Table 1.
Analysis of the DVH for PTV (D98, D2, D5∼D95 (HI), CI90, CI95).
Rt.PTV D98 (Gy) D2 (Gy) D5∼D95 (Gy) CI90 CI95
Mean±SD Mean±SD Mean±SD Mean±SD Mean±SD
8-IMRT 38.37±1.89 54.91±4.20 14.96±1.93 1.28±0.21 1.43±0.11
12-IMRT 42.94±1.62 54.48±4.11 10.69±1.62 1.07±0.06 1.17±0.07
VMAT 36.35±2.22 57.68±1.13 17.10±2.44 1.30±0.13 1.57±0.21
Lt.PTV D98 (Gy) D2 (Gy) D5∼D95 (Gy) CI90 CI95
Mean±SD Mean±SD Mean±SD Mean±SD Mean±SD
8-IMRT 38.21±4.17 56.93±0.75 15.10±3.76 1.25±0.25 1.56±0.42
12-IMRT 42.56±2.09 56.37±0.71 10.96±1.96 1.10±0.08 1.22±0.15
VMAT 36.86±5.12 58.04±0.70 16.78±4.59 1.34±0.23 1.72±0.41
Table 2.
Analysis of the DVH for OAR (Rt.lung, Lt.lung, Heart).
Rt.lung Mean (Gy) D2% (Gy) V5 Gy (%) V20 Gy (%) V45 Gy (%)
Mean±SD Mean±SD Mean±SD Mean±SD Mean±SD
8IMRT 12.20±0.32 37.85±2.03 0.78±0.14 0.18±0.03 -
12IMRT 11.80±0.75 37.35±3.19 0.80±0.18 0.17±0.03 -
VMAT 12.92±1.16 38.25±4.30 0.85±0.12 0.20±0.03 0.01±0.01
Lt.lung Mean (Gy) D2% (Gy) V5 Gy (%) V20 Gy (%) V45 Gy (%)
Mean±SD Mean±SD Mean±SD Mean±SD Mean±SD
8IMRT 12.25±0.22 38.71±3.55 0.75±0.11 0.20±0.01 0.06±0.00
12IMRT 11.86±0.63 37.97±4.01 0.80±0.18 0.17±0.02 0.04±0.00
VMAT 12.88±1.29 39.62±2.75 0.83±0.15 0.25±0.13 0.05±0.00
Heart Mean (Gy) D2% (Gy) V10 Gy (%) V45 Gy (%)  
Mean±SD Mean±SD Mean±SD Mean±SD  
8IMRT 10.68±5.11 28.67±0.83 0.61±0.11 -  
12IMRT 11.81±1.18 28.49±2.83 0.52±0.10 -  
VMAT 12.88±2.10 34.60±3.63 0.51±0.15 -  
Table 3.
Segments and number of monitor unit (MU) comparison for each plans.
    8-IMRT 12-IMRT VMAT
Patient 1 Seg. 198 225 191
  MU 1,377.66 1,447.98 1,342.75
Patient 2 Seg. 161 169 198
  MU 1,164.26 1,154.18 1,119.59
Patient 3 Seg. 167 204 193
  MU 1,132.87 1,367.49 1,366.8
Patient 4 Seg. 147 210 192
  MU 1,164.54 1,402.69 1,244.36
Patient 5 Seg. 140 187 141
  MU 922.36 1,198.57 1,046.29
Mean seg.±SD   162.6±22.52 199±21.60 183±23.63
Mean MU±SD   1,152.34±161.50 1,314.18±129.95 1,223.96±139.10

Seg.: segment, MU: monitor unit.

TOOLS
Similar articles