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HDR brachytherapy combined with 3D conformal versus IMRT in left‐sided breast cancer patients including internal mammary chain: Comparative analysis of dosimetric and technical parameters

Treatment of the internal mammary chain (IMC) with radiation therapy (RT) for patients with breast cancer remains a controversial issue. Different treatment techniques have been proposed, including oblique electrons, electron‐photon combination, and partially wide tangents (PWTs). However, the resid...

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Autores principales: Kinhikar, Rajesh Ashok, Deshpande, Sudesh Sharad, Mahantshetty, Umesh, Sarin, Rajiv, Shrivastava, Shyam Kishore, Deshpande, Deepak Dattatraya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2005
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5723489/
https://www.ncbi.nlm.nih.gov/pubmed/16143787
http://dx.doi.org/10.1120/jacmp.v6i3.2027
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author Kinhikar, Rajesh Ashok
Deshpande, Sudesh Sharad
Mahantshetty, Umesh
Sarin, Rajiv
Shrivastava, Shyam Kishore
Deshpande, Deepak Dattatraya
author_facet Kinhikar, Rajesh Ashok
Deshpande, Sudesh Sharad
Mahantshetty, Umesh
Sarin, Rajiv
Shrivastava, Shyam Kishore
Deshpande, Deepak Dattatraya
author_sort Kinhikar, Rajesh Ashok
collection PubMed
description Treatment of the internal mammary chain (IMC) with radiation therapy (RT) for patients with breast cancer remains a controversial issue. Different treatment techniques have been proposed, including oblique electrons, electron‐photon combination, and partially wide tangents (PWTs). However, the residual heart dose can remain significant mainly for left‐sided lesions. With PWTs and intensity‐modulated radiotherapy (IMRT), respiratory movement and errors in IMC localization remain a problem. The goal of this paper is to evaluate the impact of IMC brachytherapy (IMCBT) combined with 3D conformal radiotherapy (3DCRT) planning on heart, lung, and contralateral breast doses compared with IMRT. All plans including IMCBT plus 3DCRT were done on PLATO; IMRT plans were generated using the Cadplan‐Helios inverse treatment‐planning software module with the “sliding window” technique. Dose‐volume histograms (DVHs) were calculated for all volumes of interest. Conformity and homogeneity index was also calculated for the planning target volume (PTV). Dose distribution in the surrounding normal tissue was evaluated. The mean conformity of the PTV was found to be 1.06 with IMCBT plus 3DCRT and 1.12 with IMRT. The mean homogeneity (HI95/107) was found to be 1.4 with IMCBT plus 3DCRT and 3.32 with IMRT. Using the IMCBT plus 3DCRT technique, the mean dose to the heart, contralateral breast, ipsilateral lung, and contralateral lung decreased with values of 32%, 6.76%, 20% and 5.52%, respectively, compared with IMRT. This novel technique of IMCBT plus 3DCRT can potentially reduce the dose to the heart and lungs. In addition, it rivals IMRT because of its unique advantages in localization, obviating the need for respiratory gating and maximum sparing of heart and other structures. PACS numbers: 87.53.Jw, 87.53.Kn, 87.53.Mr, 87.53, 87.53.Tf
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spelling pubmed-57234892018-04-02 HDR brachytherapy combined with 3D conformal versus IMRT in left‐sided breast cancer patients including internal mammary chain: Comparative analysis of dosimetric and technical parameters Kinhikar, Rajesh Ashok Deshpande, Sudesh Sharad Mahantshetty, Umesh Sarin, Rajiv Shrivastava, Shyam Kishore Deshpande, Deepak Dattatraya J Appl Clin Med Phys Radiation Oncology Physics Treatment of the internal mammary chain (IMC) with radiation therapy (RT) for patients with breast cancer remains a controversial issue. Different treatment techniques have been proposed, including oblique electrons, electron‐photon combination, and partially wide tangents (PWTs). However, the residual heart dose can remain significant mainly for left‐sided lesions. With PWTs and intensity‐modulated radiotherapy (IMRT), respiratory movement and errors in IMC localization remain a problem. The goal of this paper is to evaluate the impact of IMC brachytherapy (IMCBT) combined with 3D conformal radiotherapy (3DCRT) planning on heart, lung, and contralateral breast doses compared with IMRT. All plans including IMCBT plus 3DCRT were done on PLATO; IMRT plans were generated using the Cadplan‐Helios inverse treatment‐planning software module with the “sliding window” technique. Dose‐volume histograms (DVHs) were calculated for all volumes of interest. Conformity and homogeneity index was also calculated for the planning target volume (PTV). Dose distribution in the surrounding normal tissue was evaluated. The mean conformity of the PTV was found to be 1.06 with IMCBT plus 3DCRT and 1.12 with IMRT. The mean homogeneity (HI95/107) was found to be 1.4 with IMCBT plus 3DCRT and 3.32 with IMRT. Using the IMCBT plus 3DCRT technique, the mean dose to the heart, contralateral breast, ipsilateral lung, and contralateral lung decreased with values of 32%, 6.76%, 20% and 5.52%, respectively, compared with IMRT. This novel technique of IMCBT plus 3DCRT can potentially reduce the dose to the heart and lungs. In addition, it rivals IMRT because of its unique advantages in localization, obviating the need for respiratory gating and maximum sparing of heart and other structures. PACS numbers: 87.53.Jw, 87.53.Kn, 87.53.Mr, 87.53, 87.53.Tf John Wiley and Sons Inc. 2005-08-17 /pmc/articles/PMC5723489/ /pubmed/16143787 http://dx.doi.org/10.1120/jacmp.v6i3.2027 Text en © 2005 The Authors. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/3.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Radiation Oncology Physics
Kinhikar, Rajesh Ashok
Deshpande, Sudesh Sharad
Mahantshetty, Umesh
Sarin, Rajiv
Shrivastava, Shyam Kishore
Deshpande, Deepak Dattatraya
HDR brachytherapy combined with 3D conformal versus IMRT in left‐sided breast cancer patients including internal mammary chain: Comparative analysis of dosimetric and technical parameters
title HDR brachytherapy combined with 3D conformal versus IMRT in left‐sided breast cancer patients including internal mammary chain: Comparative analysis of dosimetric and technical parameters
title_full HDR brachytherapy combined with 3D conformal versus IMRT in left‐sided breast cancer patients including internal mammary chain: Comparative analysis of dosimetric and technical parameters
title_fullStr HDR brachytherapy combined with 3D conformal versus IMRT in left‐sided breast cancer patients including internal mammary chain: Comparative analysis of dosimetric and technical parameters
title_full_unstemmed HDR brachytherapy combined with 3D conformal versus IMRT in left‐sided breast cancer patients including internal mammary chain: Comparative analysis of dosimetric and technical parameters
title_short HDR brachytherapy combined with 3D conformal versus IMRT in left‐sided breast cancer patients including internal mammary chain: Comparative analysis of dosimetric and technical parameters
title_sort hdr brachytherapy combined with 3d conformal versus imrt in left‐sided breast cancer patients including internal mammary chain: comparative analysis of dosimetric and technical parameters
topic Radiation Oncology Physics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5723489/
https://www.ncbi.nlm.nih.gov/pubmed/16143787
http://dx.doi.org/10.1120/jacmp.v6i3.2027
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