Amitpal Singh Saini1, Indra J Das2, Catherine S Hwang3, Matthew C Biagioli3, William E Lee4. 1. Department of Radiation Oncology, Advent Health Cancer Institute, Orlando, Florida; Department of Medical Engineering, University of South Florida, Tampa, Florida. Electronic address: amitpal97@gmail.com. 2. Department of Radiation Oncology, NYU Langone School of Medicine & Laura and Isaac Perlmutter Cancer Center, New York, New York. 3. Department of Radiation Oncology, Advent Health Cancer Institute, Orlando, Florida. 4. Department of Chemical & Biomedical Engineering, University of South Florida, Tampa, Florida.
Abstract
PURPOSE: To compare dose to organs at risk (OARs) and biological evaluation using normal tissue complication probability (NTCP) for left-sided breast radiation therapy in 4 techniques: supine free breathing (SFB), supine deep inspiration breath hold (SDIBH), prone free breathing (PFB), and prone deep inspiration breath hold (PDIBH). METHODS AND MATERIALS: Twenty-five patients with left-sided breast cancer suitable for this study underwent a computed tomography scan using SFB, SDIBH, PFB, and PDIBH. One radiation oncologist contoured the planning target volume and OAR (cardiac components). Dose-volume histograms and NTCPs for the heart, left ventricle (LV), left anterior descending artery (LAD), and left lung were calculated for all 4 techniques. RESULTS: The mean heart dose in PDIBH is 0.77 Gy, which is statistically significantly lower than in SFB (1.88 Gy, P < .0001), SDIBH (0.97 Gy, P < .001), and PFB (0.85 Gy, P < .001). The mean left lung dose is 0.69 Gy in PFB and 0.88 Gy in PDIBH. PFB and PDIBH have statistically significantly lower doses compared with SFB (6.09 Gy, P < .0001) and SDIBH (5.41 Gy, P < .0001). The mean NTCP in SFB for the heart, LV, and LAD is 0.27%, 0.62%, and 4.23%, respectively, and it is negligible for other techniques. CONCLUSIONS: We found that PDIBH had a dosimetrically lower mean dose for the heart and LV compared with the other 3 techniques. In addition, SDIBH, PFB and PDIBH had statistically significantly lower NTCP for the heart, LV, and LAD compared with SFB. NTCP for the left lung was statistically significantly lower for prone techniques compared with supine techniques. Therefore we concluded that, compared with SDIBH, PDIBH provides the added benefit of sparing the heart while keeping the benefit of sparing the lung as in the prone technique.
PURPOSE: To compare dose to organs at risk (OARs) and biological evaluation using normal tissue complication probability (NTCP) for left-sided breast radiation therapy in 4 techniques: supine free breathing (SFB), supine deep inspiration breath hold (SDIBH), prone free breathing (PFB), and prone deep inspiration breath hold (PDIBH). METHODS AND MATERIALS: Twenty-five patients with left-sided breast cancer suitable for this study underwent a computed tomography scan using SFB, SDIBH, PFB, and PDIBH. One radiation oncologist contoured the planning target volume and OAR (cardiac components). Dose-volume histograms and NTCPs for the heart, left ventricle (LV), left anterior descending artery (LAD), and left lung were calculated for all 4 techniques. RESULTS: The mean heart dose in PDIBH is 0.77 Gy, which is statistically significantly lower than in SFB (1.88 Gy, P < .0001), SDIBH (0.97 Gy, P < .001), and PFB (0.85 Gy, P < .001). The mean left lung dose is 0.69 Gy in PFB and 0.88 Gy in PDIBH. PFB and PDIBH have statistically significantly lower doses compared with SFB (6.09 Gy, P < .0001) and SDIBH (5.41 Gy, P < .0001). The mean NTCP in SFB for the heart, LV, and LAD is 0.27%, 0.62%, and 4.23%, respectively, and it is negligible for other techniques. CONCLUSIONS: We found that PDIBH had a dosimetrically lower mean dose for the heart and LV compared with the other 3 techniques. In addition, SDIBH, PFB and PDIBH had statistically significantly lower NTCP for the heart, LV, and LAD compared with SFB. NTCP for the left lung was statistically significantly lower for prone techniques compared with supine techniques. Therefore we concluded that, compared with SDIBH, PDIBH provides the added benefit of sparing the heart while keeping the benefit of sparing the lung as in the prone technique.
Authors: Bruno Speleers; Max Schoepen; Francesca Belosi; Vincent Vakaet; Wilfried De Neve; Pieter Deseyne; Leen Paelinck; Tom Vercauteren; Michael J Parkes; Tony Lomax; Annick Van Greveling; Alessandra Bolsi; Damien C Weber; Liv Veldeman; Werner De Gersem Journal: Sci Rep Date: 2021-03-16 Impact factor: 4.379
Authors: Marc Vogel; Jonas Gade; Bernd Timm; Michaela Schürmann; Hendrik Auerbach; Frank Nüsken; Christian Rübe; Patrick Melchior; Yvonne Dzierma Journal: Front Oncol Date: 2022-07-27 Impact factor: 5.738