Dosimetric comparison of simultaneous integrated boost with whole-breast irradiation for early breast cancer

PURPOSE: The purpose of this study was to identify a more suitable boost plan for simultaneously integrated boost scheme in patients with breast cancer by comparing among 3 types of whole-breast irradiation plus tumor bed boost plans. METHODS: Twenty patients who received radiotherapy following breast-conserving surgery for early breast cancer were enrolled in this study. We performed 1 type of electron plan (E1P plan) and 2 types of 3-dimensional conformal plans using a photon (P3P and P5P plans). The dosimetric parameters for the heart, total lung and the target volume between the 3 treatment types were compared. RESULTS: For the tumor bed, the difference in the mean dose between the 3 plans was maximally 0.1 Gy. For normal breast parenchyma, the difference in the mean dose between the 3 plans was maximally 1.1 Gy. In the dose range over the prescribed dose of 51 Gy, V(55) and V(60) in the E1P plan were lower than those in the P3P and P5P plans, which indicated that the E1P plan was more suitable than the P3P and P5P plans. In case of the heart and total lung, the values of clinically important parameters were slightly higher in the E1P plan than in the P3P and P5P plans. However, these differences were less than 2%. CONCLUSION: We observed that a simple electron plan for tumor bed boost is preferable over multi-field photon plans in terms of the target volume coverage and normal tissue sparing.