Radiotherapy & Oncology
Volume 94, Issue 3 , Pages 313-318, March 2010

Comparison of electron IMRT to helical photon IMRT and conventional photon irradiation for treatment of breast and chest wall tumours

  • Tobias Gauer

      Affiliations

    • Department of Radiotherapy and Radio-Oncology, University Medical Center Hamburg-Eppendorf, Germany
    • Corresponding Author InformationCorresponding author. Address: Department of Radiotherapy and Radio-Oncology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
    • ,
  • Konrad Engel

      Affiliations

    • Institute for Mathematics, University of Rostock, Germany
    • ,
  • Antje Kiesel

      Affiliations

    • Institute for Mathematics, University of Rostock, Germany
    • ,
  • Dirk Albers

      Affiliations

    • Department of Radiotherapy and Radio-Oncology, University Medical Center Hamburg-Eppendorf, Germany
    • ,
  • Dirk Rades

      Affiliations

    • Department of Radiation Oncology, University Hospital Schleswig-Holstein, Lübeck, Germany

Received 6 March 2009; received in revised form 30 December 2009; accepted 30 December 2009. published online 01 February 2010.

Abstract 

Background and purpose

Conventional irradiation of breast and chest wall tumours may cause high doses in underlying organs. Intensity-modulated radiation therapy (IMRT) with photons achieves high conformity between treated and tumour volume but is associated with considerable low-dose effects which may induce secondary malignancies. We compare treatment plans of electron IMRT to helical photon IMRT and conventional irradiation.

Material and methods

Treatment planning for three patients (breast, chest wall plus lymph nodes, sarcoma of medial chest wall/sternum) was performed using XiO 4.3.3 (CMS) for conventional photon irradiation, Hi-Art 2.2.2.05 (TomoTherapy) for helical photon IMRT, and a self-designed programme for electron IMRT.

Results

The techniques resulted in similar mean and maximum target doses. Target coverage by the 95%-isodose was best with tomotherapy. Mean ipsilateral lung doses were similar with all techniques. Electron IMRT achieved best sparing of heart, and contralateral breast. Compared with photon IMRT, electron IMRT allowed better sparing of contralateral lung and total healthy tissue.

Conclusions

Electron IMRT is superior to conventional irradiation, as it allows satisfying target coverage and avoids high doses in underlying organs. Its advantage over photon IMRT is better sparing of most organs at risk (low-dose effects) which reduces the risk of radiation-induced malignancies.

Keywords: Breast cancer, Chest wall tumours, Helical photon beams, Electron radiotherapy, Electron MLC

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PII: S0167-8140(10)00014-9

doi:10.1016/j.radonc.2009.12.037

Radiotherapy & Oncology
Volume 94, Issue 3 , Pages 313-318, March 2010

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