Does inverse-planned intensity-modulated radiation therapy have a role in the treatment of patients with left-sided breast cancer?

作者：Stillie Alison L; Kron Tomas^*; Herschtal Alan; Hornby Colin; Cramb Jim; Sullivan Kelly; Chua Boon

来源：Journal of Medical Imaging and Radiation Oncology, 2011, 55(3): 311-319.

DOI：10.1111/j.1754-9485.2011.02273.x

• breast cancer
• IMRT
• radiation treatment planning

Introduction: The purpose of the study was to determine if multi-field inverse-planned intensity-modulated radiation therapy (IMRT) improves on the sparing of organs at risk (heart, lungs and contralateral breast) when compared with field-in-field forward-planned RT (FiF).
Methods: The planning CT scans of 10 women with left-sided breast cancer previously treated with whole-breast RT on an inclined breast board with both arms supported above the head were retrieved. The whole breast planning target volume (PTV) was defined by clinical mark-up and contoured on all relevant CT slices as were the organs at risk. For each patient, three plans were generated using FiF, five-and nine-field inverse-planned IMRT, all to a total dose of 50 Gy to the whole breast. Mean and maximum doses to the organs at risk and the homogeneity index (HI) of the whole-breast PTV were compared. Results: The mean heart dose for the FiF plans was 2.63 Gy compared with 4.04 Gy for the five-field and 4.30 Gy for the nine-field IMRT plans, with no significant differences in the HI of the whole-breast PTV in all plans. The FiF plans resulted in a mean contralateral breast dose of 0.58 Gy compared with 0.70 and 2.08 Gy for the five-and nine-field IMRT plans, respectively.
Conclusions: FiF resulted in a lower mean heart and contralateral breast dose with comparable HI of the whole-breast PTV in comparison with inverse-planned IMRT using five or nine fields.

• 出版日期2011-6