Whole breast and excision cavity radiotherapy plan comparison: conformal radiotherapy with sequential boost versus intensity-modulated radiation therapy with a simultaneously integrated boost
Introduction A comparative study was conducted comparing the difference between (1) conformal radiotherapy (CRT) to the whole breast with sequential boost excision cavity plans and (2) intensity‐modulated radiation therapy (IMRT) to the whole breast with simultaneously integrated boost to the excisi...
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| description | Introduction
A comparative study was conducted comparing the difference between (1) conformal radiotherapy (CRT) to the whole breast with sequential boost excision cavity plans and (2) intensity‐modulated radiation therapy (IMRT) to the whole breast with simultaneously integrated boost to the excision cavity. The computed tomography (CT) data sets of 25 breast cancer patients were used and the results analysed to determine if either planning method produced superior plans.
Methods
CT data sets from 25 past breast cancer patients were planned using (1) CRT prescribed to 50 Gy in 25 fractions (Fx) to the whole‐breast planning target volume (PTV) and 10 Gy in 5Fx to the excision cavity and (2) IMRT prescribed to 60 Gy in 25Fx, with 60 Gy delivered to the excision cavity PTV and 50 Gy delivered to the whole‐breast PTV, treated simultaneously. In total, 50 plans were created, with each plan evaluated by PTV coverage using conformity indices, plan maximum dose, lung dose, and heart maximum dose for patients with left‐side lesions.
Results
CRT plans delivered the lowest plan maximum doses in 56% of cases (average CRT = 6314.34 cGy, IMRT = 6371.52 cGy). They also delivered the lowest mean lung dose in 68% of cases (average CRT = 1206.64 cGy, IMRT = 1288.37 cGy) and V20 in 88% of cases (average CRT = 20.03%, IMRT = 21.73%) and V30 doses in 92% of cases (average CRT = 16.82%, IMRT = 17.97%). IMRT created more conformal plans, using both conformity index and conformation number, in every instance, and lower heart maximum doses in 78.6% of cases (average CRT = 5295.26 cGy, IMRT = 5209.87 cGy).
Conclusion
IMRT plans produced superior dose conformity and shorter treatment duration, but a slightly higher planning maximum and increased lung doses. IMRT plans are also faster to treat on a daily basis, with shorter fractionation.
A comparative study comparing the difference between conformally planned whole breast with sequential boost excision cavity plans and IMRT planned whole breast with an integrated boost excision cavity plans, using 25 patient data‐sets. Each plan was evaluated using planning target volume coverage, plan maximum dose, lung dose, and heart maximum dose for patients with left‐side lesions. |
| doi_str_mv | 10.1002/jmrs.4 |
| format | Article |
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A comparative study was conducted comparing the difference between (1) conformal radiotherapy (CRT) to the whole breast with sequential boost excision cavity plans and (2) intensity‐modulated radiation therapy (IMRT) to the whole breast with simultaneously integrated boost to the excision cavity. The computed tomography (CT) data sets of 25 breast cancer patients were used and the results analysed to determine if either planning method produced superior plans.
Methods
CT data sets from 25 past breast cancer patients were planned using (1) CRT prescribed to 50 Gy in 25 fractions (Fx) to the whole‐breast planning target volume (PTV) and 10 Gy in 5Fx to the excision cavity and (2) IMRT prescribed to 60 Gy in 25Fx, with 60 Gy delivered to the excision cavity PTV and 50 Gy delivered to the whole‐breast PTV, treated simultaneously. In total, 50 plans were created, with each plan evaluated by PTV coverage using conformity indices, plan maximum dose, lung dose, and heart maximum dose for patients with left‐side lesions.
Results
CRT plans delivered the lowest plan maximum doses in 56% of cases (average CRT = 6314.34 cGy, IMRT = 6371.52 cGy). They also delivered the lowest mean lung dose in 68% of cases (average CRT = 1206.64 cGy, IMRT = 1288.37 cGy) and V20 in 88% of cases (average CRT = 20.03%, IMRT = 21.73%) and V30 doses in 92% of cases (average CRT = 16.82%, IMRT = 17.97%). IMRT created more conformal plans, using both conformity index and conformation number, in every instance, and lower heart maximum doses in 78.6% of cases (average CRT = 5295.26 cGy, IMRT = 5209.87 cGy).
Conclusion
IMRT plans produced superior dose conformity and shorter treatment duration, but a slightly higher planning maximum and increased lung doses. IMRT plans are also faster to treat on a daily basis, with shorter fractionation.
A comparative study comparing the difference between conformally planned whole breast with sequential boost excision cavity plans and IMRT planned whole breast with an integrated boost excision cavity plans, using 25 patient data‐sets. Each plan was evaluated using planning target volume coverage, plan maximum dose, lung dose, and heart maximum dose for patients with left‐side lesions.</description><identifier>ISSN: 2051-3895</identifier><identifier>EISSN: 2051-3909</identifier><identifier>DOI: 10.1002/jmrs.4</identifier><identifier>PMID: 26229603</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Breast cancer ; Cancer ; Cancer therapies ; CAVITIES ; Chemotherapy ; COMPUTERIZED TOMOGRAPHY ; conformal radiotherapy ; DOSES ; FRACTIONATION ; HEART ; INDEXES ; intensity‐modulated radiotherapy (IMRT) ; lung dose ; LUNGS ; MAMMARY GLANDS ; Mammography ; NEOPLASMS ; Original ; PATIENTS ; PLANNING ; Radiation ; Radiation therapy ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIOTHERAPY ; Surgery ; Therapy ; Women and health</subject><ispartof>Journal of medical radiation sciences, 2013-03, Vol.60 (1), p.16-24</ispartof><rights>2013 The Authors. published by Wiley Publishing Asia Pty Ltd on behalf of Australian Institute of Radiography and New Zealand Institute of Medical Radiation Technology.</rights><rights>2013 Australian Institute of Radiography</rights><rights>2013. This work is published under http://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2013 Australian Institute of Radiography 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5474-75db613d945ff1a079e9524a7b355065fcaf4acea965b8280405b152a9ec04563</citedby><cites>FETCH-LOGICAL-c5474-75db613d945ff1a079e9524a7b355065fcaf4acea965b8280405b152a9ec04563</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4175795/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4175795/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,1411,11541,27901,27902,45550,45551,46027,46451,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26229603$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/22402326$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Small, Katherine</creatorcontrib><creatorcontrib>Kelly, Chris</creatorcontrib><creatorcontrib>Beldham‐Collins, Rachael</creatorcontrib><creatorcontrib>Gebski, Val</creatorcontrib><title>Whole breast and excision cavity radiotherapy plan comparison: conformal radiotherapy with sequential boost versus intensity-modulated radiation therapy with a simultaneously integrated boost</title><title>Journal of medical radiation sciences</title><addtitle>J Med Radiat Sci</addtitle><description>Introduction
A comparative study was conducted comparing the difference between (1) conformal radiotherapy (CRT) to the whole breast with sequential boost excision cavity plans and (2) intensity‐modulated radiation therapy (IMRT) to the whole breast with simultaneously integrated boost to the excision cavity. The computed tomography (CT) data sets of 25 breast cancer patients were used and the results analysed to determine if either planning method produced superior plans.
Methods
CT data sets from 25 past breast cancer patients were planned using (1) CRT prescribed to 50 Gy in 25 fractions (Fx) to the whole‐breast planning target volume (PTV) and 10 Gy in 5Fx to the excision cavity and (2) IMRT prescribed to 60 Gy in 25Fx, with 60 Gy delivered to the excision cavity PTV and 50 Gy delivered to the whole‐breast PTV, treated simultaneously. In total, 50 plans were created, with each plan evaluated by PTV coverage using conformity indices, plan maximum dose, lung dose, and heart maximum dose for patients with left‐side lesions.
Results
CRT plans delivered the lowest plan maximum doses in 56% of cases (average CRT = 6314.34 cGy, IMRT = 6371.52 cGy). They also delivered the lowest mean lung dose in 68% of cases (average CRT = 1206.64 cGy, IMRT = 1288.37 cGy) and V20 in 88% of cases (average CRT = 20.03%, IMRT = 21.73%) and V30 doses in 92% of cases (average CRT = 16.82%, IMRT = 17.97%). IMRT created more conformal plans, using both conformity index and conformation number, in every instance, and lower heart maximum doses in 78.6% of cases (average CRT = 5295.26 cGy, IMRT = 5209.87 cGy).
Conclusion
IMRT plans produced superior dose conformity and shorter treatment duration, but a slightly higher planning maximum and increased lung doses. IMRT plans are also faster to treat on a daily basis, with shorter fractionation.
A comparative study comparing the difference between conformally planned whole breast with sequential boost excision cavity plans and IMRT planned whole breast with an integrated boost excision cavity plans, using 25 patient data‐sets. Each plan was evaluated using planning target volume coverage, plan maximum dose, lung dose, and heart maximum dose for patients with left‐side lesions.</description><subject>Breast cancer</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>CAVITIES</subject><subject>Chemotherapy</subject><subject>COMPUTERIZED TOMOGRAPHY</subject><subject>conformal radiotherapy</subject><subject>DOSES</subject><subject>FRACTIONATION</subject><subject>HEART</subject><subject>INDEXES</subject><subject>intensity‐modulated radiotherapy (IMRT)</subject><subject>lung dose</subject><subject>LUNGS</subject><subject>MAMMARY GLANDS</subject><subject>Mammography</subject><subject>NEOPLASMS</subject><subject>Original</subject><subject>PATIENTS</subject><subject>PLANNING</subject><subject>Radiation</subject><subject>Radiation therapy</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>RADIOTHERAPY</subject><subject>Surgery</subject><subject>Therapy</subject><subject>Women and health</subject><issn>2051-3895</issn><issn>2051-3909</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kttu1DAQQCMEolUpn4AiISF42OJrEvOAhCrKRUVIXMSjNXGcjVdOnNrOlv06fg1n0y70AZ480pw5Y48nyx5jdIYRIi83vQ9n7F52TBDHKyqQuH8bV4IfZachbBBCGJWECPQwOyJFCgpEj7NfPzpndV57DSHmMDS5_qlMMG7IFWxN3OUeGuNipz2Mu3y0kBKuH8Gb4IZXKR5a53uwd7lrE7s86KtJD9GkZO1c0m-1D1PIzRD1EJJ71btmshB1s6-GOLe9o4A8mH6yEQbtpmB3-9q135fsnY-yBy3YoE9vzpPs-8Xbb-fvV5ef3304f3O5UpyVbFXypi4wbQTjbYsBlUILThiUNeUcFbxV0DJQGkTB64pUiCFeY05AaIUYL-hJ9nrxjlPd60ald3mwcvSmB7-TDoy8mxlMJ9duKxkueSl4EjxdBOnSRgZlolZdmt6gVZSEMEQomds8v2njXRpeiLI3QWlrlwFIXCJMCSto-Ud4QDdu8kMagpx_GZXp3uJ_FC5oxSiuiipRzxZKeReC1-3hYRjJecXkvGKSJfDJ32M4YLcLlYAXC3BtrN79QyM_fvrydZZdLKzvTZQwQhtlF-MYZAMRpNlvVso4v5aNM7OEUlxIo22CJUGYEESxoL8B1qz4Tg</recordid><startdate>201303</startdate><enddate>201303</enddate><creator>Small, Katherine</creator><creator>Kelly, Chris</creator><creator>Beldham‐Collins, Rachael</creator><creator>Gebski, Val</creator><general>Wiley Subscription Services, Inc</general><general>John Wiley & Sons, Inc</general><general>Blackwell Publishing Ltd</general><scope>24P</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88I</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>OTOTI</scope><scope>5PM</scope></search><sort><creationdate>201303</creationdate><title>Whole breast and excision cavity radiotherapy plan comparison: conformal radiotherapy with sequential boost versus intensity-modulated radiation therapy with a simultaneously integrated boost</title><author>Small, Katherine ; Kelly, Chris ; Beldham‐Collins, Rachael ; Gebski, Val</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5474-75db613d945ff1a079e9524a7b355065fcaf4acea965b8280405b152a9ec04563</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Breast cancer</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>CAVITIES</topic><topic>Chemotherapy</topic><topic>COMPUTERIZED TOMOGRAPHY</topic><topic>conformal radiotherapy</topic><topic>DOSES</topic><topic>FRACTIONATION</topic><topic>HEART</topic><topic>INDEXES</topic><topic>intensity‐modulated radiotherapy (IMRT)</topic><topic>lung dose</topic><topic>LUNGS</topic><topic>MAMMARY GLANDS</topic><topic>Mammography</topic><topic>NEOPLASMS</topic><topic>Original</topic><topic>PATIENTS</topic><topic>PLANNING</topic><topic>Radiation</topic><topic>Radiation therapy</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>RADIOTHERAPY</topic><topic>Surgery</topic><topic>Therapy</topic><topic>Women and health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Small, Katherine</creatorcontrib><creatorcontrib>Kelly, Chris</creatorcontrib><creatorcontrib>Beldham‐Collins, Rachael</creatorcontrib><creatorcontrib>Gebski, Val</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of medical radiation sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Small, Katherine</au><au>Kelly, Chris</au><au>Beldham‐Collins, Rachael</au><au>Gebski, Val</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Whole breast and excision cavity radiotherapy plan comparison: conformal radiotherapy with sequential boost versus intensity-modulated radiation therapy with a simultaneously integrated boost</atitle><jtitle>Journal of medical radiation sciences</jtitle><addtitle>J Med Radiat Sci</addtitle><date>2013-03</date><risdate>2013</risdate><volume>60</volume><issue>1</issue><spage>16</spage><epage>24</epage><pages>16-24</pages><issn>2051-3895</issn><eissn>2051-3909</eissn><abstract>Introduction
A comparative study was conducted comparing the difference between (1) conformal radiotherapy (CRT) to the whole breast with sequential boost excision cavity plans and (2) intensity‐modulated radiation therapy (IMRT) to the whole breast with simultaneously integrated boost to the excision cavity. The computed tomography (CT) data sets of 25 breast cancer patients were used and the results analysed to determine if either planning method produced superior plans.
Methods
CT data sets from 25 past breast cancer patients were planned using (1) CRT prescribed to 50 Gy in 25 fractions (Fx) to the whole‐breast planning target volume (PTV) and 10 Gy in 5Fx to the excision cavity and (2) IMRT prescribed to 60 Gy in 25Fx, with 60 Gy delivered to the excision cavity PTV and 50 Gy delivered to the whole‐breast PTV, treated simultaneously. In total, 50 plans were created, with each plan evaluated by PTV coverage using conformity indices, plan maximum dose, lung dose, and heart maximum dose for patients with left‐side lesions.
Results
CRT plans delivered the lowest plan maximum doses in 56% of cases (average CRT = 6314.34 cGy, IMRT = 6371.52 cGy). They also delivered the lowest mean lung dose in 68% of cases (average CRT = 1206.64 cGy, IMRT = 1288.37 cGy) and V20 in 88% of cases (average CRT = 20.03%, IMRT = 21.73%) and V30 doses in 92% of cases (average CRT = 16.82%, IMRT = 17.97%). IMRT created more conformal plans, using both conformity index and conformation number, in every instance, and lower heart maximum doses in 78.6% of cases (average CRT = 5295.26 cGy, IMRT = 5209.87 cGy).
Conclusion
IMRT plans produced superior dose conformity and shorter treatment duration, but a slightly higher planning maximum and increased lung doses. IMRT plans are also faster to treat on a daily basis, with shorter fractionation.
A comparative study comparing the difference between conformally planned whole breast with sequential boost excision cavity plans and IMRT planned whole breast with an integrated boost excision cavity plans, using 25 patient data‐sets. Each plan was evaluated using planning target volume coverage, plan maximum dose, lung dose, and heart maximum dose for patients with left‐side lesions.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>26229603</pmid><doi>10.1002/jmrs.4</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | Wiley Online Library Open Access; DOAJ Directory of Open Access Journals; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Breast cancer Cancer Cancer therapies CAVITIES Chemotherapy COMPUTERIZED TOMOGRAPHY conformal radiotherapy DOSES FRACTIONATION HEART INDEXES intensity‐modulated radiotherapy (IMRT) lung dose LUNGS MAMMARY GLANDS Mammography NEOPLASMS Original PATIENTS PLANNING Radiation Radiation therapy RADIOLOGY AND NUCLEAR MEDICINE RADIOTHERAPY Surgery Therapy Women and health |
| title | Whole breast and excision cavity radiotherapy plan comparison: conformal radiotherapy with sequential boost versus intensity-modulated radiation therapy with a simultaneously integrated boost |
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