Comparison of Lung and Contralateral Scattered Breast Dose between Field-in-Field and Wedge Techniques in Patients with Early Breast Cancer
,
Abstract
Purpose: This study aims to evaluate the dosimetric result of the Field-In-Field (FIF) plans compared with Tangential Wedged Beams (TWB) plans for whole breast radiotherapy of patients.
Materials and Methods: In this survey, we entered fifty patients with breast-conserving surgery and postoperative whole-breast radiotherapy. FIF and a TWB plan were made for each patient to compare dosimetric outcomes.
Results: The Homogeneity Index (HI) and Conformity Index (CI) were specified for the evaluation of Planning Target Volume (PTV). The mean dose of the ipsilateral lung and contra-lateral breast for the evaluation of organs at risk dose were used. The FIF plans had significantly lower HI (p < 0.01) and CI (p < 0.01) than those of the TWB plans. It means in the dosimetric comparisons of the PTV, the FIF plans were better than the TWB plans. The V10lung (31.152vs. 32.72%, p < 0.01), V20lung (25.6064vs. 26.6%, p < 0.01) V30lung (17.4% vs. 18.4%, p < 0.01) were lower with the FIF plans compared with those of the TWB plans, with statistical significance. The FIF plans had a lower mean dose for the lung than those of TWB plans (1225.48 vs. 1670.32 cGy) but no statistical significance (p=0.06). The mean dose in the contra-lateral of the breast in FIF plans was lower than in TWB plans (61.666 vs. 163.45 cGy), with statistical significance (p < 0.01).
Conclusion: The FIF plans increased the dose homogeneity, and conformity of the target volume for the whole-breast irradiation compared with the TWB plans contralateral breast. Moreover, the doses of organs at risk (ipsilateral lung and contralateral breast) were reduced with FIF plans.
2- Todd Yoder, An Ting Hsia, Zhigang Xu, Alexander Stessin, and Samuel Ryu, "Usefulness of EZFluence software for radiotherapy planning of breast cancer treatment." Medical Dosimetry, Vol. 44 (No. 4), pp. 339-43, (2019).
3- Suzy Kim and Yunseok Choi, "Dosimetric advantages of the field-in-field plan compared with the tangential wedged beams plan for whole-breast irradiation." Progress in Medical Physics, Vol. 25 (No. 4), pp. 199-204, (2014).
4- Early Breast Cancer Trialists’ Collaborative Group, "Darby S, McGale P, Correa C, Taylor C, Arriagada R, et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials." Lancet, Vol. 378 (No. 9804), pp. 1707-16, (2011).
5- Hilal SARAÇ CANBOLAT, Niyazi Volkan DEMIRCAN, Serap ÇATLI DINÇ, Ertuğrul ŞENTÜRK, and BORA Hüseyin, "Dosimetric Investigation of FIF, VMAT, IMRT, H-VMAT, and H-IMRT Planning Techniques in Breast Cancer Radiotherapy." TURKISH JOURNAL OF ONCOLOGY, Vol. 1 (No. 1), (2023).
6- Zakiya Salem Al-Rahbi et al., "Dosimetric comparison of intensity modulated radiotherapy isocentric field plans and field in field (FIF) forward plans in the treatment of breast cancer." Journal of Medical Physics/Association of Medical Physicists of India, Vol. 38 (No. 1), p. 22, (2013).
7- Vishnu R Nambiar, Dinesh Makuny, and Beena Kunheri, "Breast Radiation Therapy Techniques." in Management of Early Stage Breast Cancer: Springer, (2021), pp. 203-15.
8- Kuo Men et al., "Fully automatic and robust segmentation of the clinical target volume for radiotherapy of breast cancer using big data and deep learning." Physica Medica, Vol. 50pp. 13-19, (2018).
9- Coen W Hurkmans, Jacques H Borger, Bradley R Pieters, Nicola S Russell, Edwin PM Jansen, and Ben J Mijnheer, "Variability in target volume delineation on CT scans of the breast." International Journal of Radiation Oncology* Biology* Physics, Vol. 50 (No. 5), pp. 1366-72, (2001).
10- Deva Petrova, Snezana Smickovska, and Emilija Lazarevska, "Conformity index and homogeneity index of the postoperative whole breast radiotherapy." Open access Macedonian journal of medical sciences, Vol. 5 (No. 6), p. 736, (2017).
11- Loic Feuvret, Georges Noël, Jean-Jacques Mazeron, and Pierre Bey, "Conformity index: a review." International Journal of Radiation Oncology* Biology* Physics, Vol. 64 (No. 2), pp. 333-42, (2006).
12- Masahiro Sasaoka and Tomoyuki Futami, "Dosimetric evaluation of whole breast radiotherapy using field-in-field technique in early-stage breast cancer." International journal of clinical oncology, Vol. 16 (No. 3), pp. 250-56, (2011).
13- Paiman Ghafoori, Lawrence B Marks, MD Zeljko Vujaskovic, and Christopher R Kelsey, "Radiation-induced lung injury: assessment, management, and prevention." Oncology, Vol. 22 (No. 1), p. 37, (2008).
14- Xiao-Jing Zhang et al., "Prediction of radiation pneumonitis in lung cancer patients: a systematic review." Journal of cancer research and clinical oncology, Vol. 138 (No. 12), pp. 2103-16, (2012).
15- Yerko O Borghero et al., "Multileaf field-in-field forward-planned intensity-modulated dose compensation for whole-breast irradiation is associated with reduced contralateral breast dose: a phantom model comparison." Radiotherapy and Oncology, Vol. 82 (No. 3), pp. 324-28, (2007).
16- Tülay Ercan et al., "Dosimetric comparison of field in field intensity-modulated radiotherapy technique with conformal radiotherapy techniques in breast cancer." Japanese journal of radiology, Vol. 28pp. 283-89, (2010).
| Files | ||
| Issue | Vol 11 No 3 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/fbt.v11i3.15892 | |
| Keywords | ||
| Breast Cancer Radiotherapy Radiation Dose Field In Field Technique | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
