Abstract
Background and purpose
As an alternative to whole breast irradiation in early breast cancer, a variety of
accelerated partial breast irradiation (APBI) techniques have been investigated. The
purpose of our study is to compare the dosimetry of four different external beam APBI
(EB-APBI) plans: three-dimensional conformal radiation therapy (3D-CRT), intensity-modulated
radiation therapy (IMRT), helical tomotherapy (TOMO), and proton beam therapy (PBT).
Methods and materials
Thirty patients were included in the study, and plans for four techniques were developed
for each patient. A total dose of 30 Gy in 6 Gy fractions once daily was prescribed in all treatment plans.
Results
In the analysis of the non-PTV breast volume that was delivered 50% of the prescribed
dose (PD), PBT (mean: 16.5%) was superior to TOMO (mean: 22.8%), IMRT (mean: 33.3%),
and 3D-CRT (mean: 40.9%) (p < 0.001). The average ipsilateral lung volume percentage receiving 20% of the PD was
significantly lower in PBT (0.4%) and IMRT (2.3%) compared with 3D-CRT (6.0%) and
TOMO (14.2%) (p < 0.001). The average heart volume percentage receiving 20% and 10% of the PD in left-sided
breast cancer (N = 19) was significantly larger with TOMO (8.0%, 19.4%) compared to 3D-CRT (1.5%, 3.1%),
IMRT (1.2%, 4.0%), and PBT (0%, 0%) (p < 0.001).
Conclusions
All four EB-APBI techniques showed acceptable coverage of the PTV. However, effective
non-PTV breast sparing was achieved at the cost of considerable dose exposure to the
lung and heart in TOMO.
Keywords
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Article info
Publication history
Published online: November 07, 2008
Accepted:
September 13,
2008
Received in revised form:
September 11,
2008
Received:
May 29,
2008
Identification
Copyright
© 2008 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
