Simultaneous-integrated boost intensity-modulated radiation therapy (SIB-IMRT) in the treatment of early-stage left-sided breast carcinoma

Journal Article · Sun Oct 01 04:00:00 EDT 2006 · Medical Dosimetry

DOI:https://doi.org/10.1016/j.meddos.2005.11.001· OSTI ID:20858074

Singla, Rajanish ^[1]; King, Stephanie C ^[1]; Albuquerque, Kevin ^[1]; Creech, Steve M.S. ^[1]; Dogan, Nesrin ^[1]

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1. Department of Radiation Oncology, Loyola University Medical Center, Maywood, IL (United States)

We assessed the feasibility and impact of simultaneous-integrated boost intensity-modulated radiation therapy (SIB-IMRT) in the treatment of left breast carcinoma and compared target coverage and normal tissue doses with SIB-IMRT and 3-dimensional (3D) conformal RT using opposed tangential fields. For each of 10 patients with early-stage left-sided invasive breast carcinoma, 5 plans were generated; the first 4 were 3D conformal opposed tangential fields-2 with wedges, 2 with compensators and either photon or electron boost. A dose of 50.4 Gy in 28 fractions was prescribed to the left breast and an additional 16 Gy in 8 fractions to the lumpectomy bed. When compared to the tangential plans, SIB-IMRT maintained coverage (V{sub 95%}) to the left breast and lumpectomy bed without significantly increasing the left breast maximum dose. SIB-IMRT was able to reduce the lung mean dose, maximum dose, and the V{sub 20} by 55-104 cGy, 983-1298 cGy (p < 0.001), and 3.7-4.4%, respectively. In addition, SIB-IMRT reduced the maximum heart dose by 1032-1173 cGy and contralateral breast dose was increased (although p = NS). The mean and maximum dose to the unspecified tissues was also significantly reduced by 81-88 cGy and 516-942 cGy, respectively. SIB-IMRT resulted in a significant improvement in target dose conformality by up to 67%. Our findings that SIB-IMRT could improve dose conformality, reduce total treatment times, and reduce some of the normal structure doses presents it as an alternative technique for adjuvant breast radiotherapy; however this needs to be studied further in the clinic setting.

• OSTI ID: 20858074
• Journal Information: Medical Dosimetry, Journal Name: Medical Dosimetry Journal Issue: 3 Vol. 31; ISSN 0958-3947; ISSN MEDOEJ
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
HEART
LUNGS
MAMMARY GLANDS
PATIENTS
PHOTONS
RADIATION DOSES
RADIOTHERAPY