Radiotherapy & Oncology
Volume 90, Issue 1 , Pages 99-105, January 2009

Helical tomotherapy for locoregional irradiation including the internal mammary chain in left-sided breast cancer: Dosimetric evaluation

  • Jean-Michel Caudrelier

      Affiliations

    • Department of Radiation Oncology, The Ottawa Hospital Cancer Centre, Ont., Canada
    • Corresponding Author InformationCorresponding author. Address: Department of Radiation Oncology, The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Ont., Canada.
    • ,
  • Scott C. Morgan

      Affiliations

    • Department of Radiation Oncology, The Ottawa Hospital Cancer Centre, Ont., Canada
    • ,
  • Lynn Montgomery

      Affiliations

    • Department of Radiation Oncology, The Ottawa Hospital Cancer Centre, Ont., Canada
    • ,
  • Manon Lacelle

      Affiliations

    • Department of Radiation Oncology, The Ottawa Hospital Cancer Centre, Ont., Canada
    • ,
  • Balazs Nyiri

      Affiliations

    • Department of Medical Physics, The Ottawa Hospital Cancer Centre, Ont., Canada
    • ,
  • Miller MacPherson

      Affiliations

    • Department of Medical Physics, The Ottawa Hospital Cancer Centre, Ont., Canada

Received 28 May 2008; received in revised form 28 August 2008; accepted 7 September 2008. published online 03 November 2008.

Abstract 

Purpose

To compare a standard 3- or 4-field technique to intensity modulated radiotherapy with helical tomotherapy (IMRT-HT) in the planning of locoregional breast radiation including the internal mammary chain (IMC).

Methods and materials

For 10 women with stage III left-sided breast cancer with a planning target volume (PTV) defined by the breast/chest wall and regional nodes, radiotherapy to a dose of 50 Gy in 25 fractions was planned using a standard 3- or 4-field technique and using IMRT-HT. Various metrics were extracted from dose–volume histograms, and were compared using the paired Student’s t-test.

Results

The PTV receiving at least 95% of the prescribed dose did not differ between the two plans, but the VD115% was significantly lower with IMRT-HT. The dose conformality was significantly better with IMRT-HT. The cardiac V30Gy was reduced with IMRT-HT. The mean lungs dose was lower with IMRT-HT, as well the V20Gy. With IMRT-HT, a greater volume of contralateral breast was irradiated to 5 Gy, but a smaller volume of soft tissue received dose above 50 Gy.

Conclusions

Compared to a standard technique, IMRT-HT provides similar target coverage, improves dose conformality and dose homogeneity within the PTV, decreases mean lung dose and spares heart, lung and soft tissue from high dose exposure.

Keywords: Breast cancer, Radiotherapy planning, Intensity-modulated radiotherapy, Helical tomotherapy, Internal mammary nodes

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PII: S0167-8140(08)00477-5

doi:10.1016/j.radonc.2008.09.028

Radiotherapy & Oncology
Volume 90, Issue 1 , Pages 99-105, January 2009

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