좌측 유방 및 주변 조직에 대한 방사선 치료 방법별 선량 평가 연구
A Dosimetric Comparison of Radiotherapy Techniques for the Left Breast and Surrounding Tissues
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
This study aims to compare the dose distribution and effects on normal tissues of four radiotherapy techniques (Wedge filter, Field-in-Field(FIF), Intensity Modulated Radiation Therapy(IMRT), and Volumetric Modulated Arc Therapy(VMAT)) for left breast cancer. In the evaluation of the planning target volume(PTV), IMRT and VMAT provided uniform dose distribution and demonstrated high conformity indices, however resulted in relatively higher radiation exposure to the heart and contralateral breast. While IMRT and VMAT showed excellent treatment effects on the PTV, they also led to increased radiation exposure to the heart and lung in the low-dose regions. Conversely, the Wedge and FIF techniques were advantageous in reducing radiation exposure to normal tissues. These findings suggest that advanced radiotherapy techniques(IMRT, VMAT) are effective for treating left breast cancer, however additional protective strategies are required to minimize radiation exposure to the heart and contralateral breast. Specifically, the use of Deep Inspiration Breath Hold (DIBH) for heart protection is recommended. Thus, this study contributes to establishing an optimal treatment plan that balances tumor treatment efficacy with the protection of normal tissues in left breast cancer radiotherapy.
Abstract
This study aims to compare the dose distribution and effects on normal tissues of four radiotherapy techniques (Wedge filter, Field-in-Field(FIF), Intensity Modulated Radiation Therapy(IMRT), and Volumetric Modulated Arc Therapy(VMAT)) for left breast cancer. In the evaluation of the planning target volume(PTV), IMRT and VMAT provided uniform dose distribution and demonstrated high conformity indices, however resulted in relatively higher radiation exposure to the heart and contralateral breast. While IMRT and VMAT showed excellent treatment effects on the PTV, they also led to increased radiation exposure to the heart and lung in the low-dose regions. Conversely, the Wedge and FIF techniques were advantageous in reducing radiation exposure to normal tissues. These findings suggest that advanced radiotherapy techniques(IMRT, VMAT) are effective for treating left breast cancer, however additional protective strategies are required to minimize radiation exposure to the heart and contralateral breast. Specifically, the use of Deep Inspiration Breath Hold (DIBH) for heart protection is recommended. Thus, this study contributes to establishing an optimal treatment plan that balances tumor treatment efficacy with the protection of normal tissues in left breast cancer radiotherapy.
참고문헌 (21)
- Siegel RL, "Cancer statistics, 2020", CA : A Cancer J Clin, 70(3), pp.145~164 (2020)[DOI]
- Lin JF, "Dosimetric comparison of hybrid volumetric-modulated arc therapy, volumetric-modulated arc therapy, and intensity-modulated radiation therapy for left-sided early breast cancer", Medical Dosimetry, 40(3), pp.262~267 (2015)[DOI]
- Lee BR, "Dosimetric comparison of radiation treatment techniques for breast cancer : 3D-CRT, IMRT and VMAT", J Radiol Sci Technol, 36(3), pp.237~244 (2013)
- Liu H, "Evaluation of 3D-CRT, IMRT and VMAT radiotherapy plans for left breast cancer based on clinical dosimetric study", Computerized Medical Imaging and Graphics, 54, pp.1~5 (2016)[DOI]
- Abo-Madyan Y, "Second cancer risk after 3D-CRT, IMRT and VMAT for breast cancer", Radiotherapy and Oncology, 110(3), pp.471~476 (2014)[DOI]
- Eckhoff L, "TAXTOX-A retrospective study regarding the side effects of docetaxel given as part of the adjuvant treatment to patients with primary breast cancer in Denmark from 2007 to 2009", Acta Oncol, 50(7), pp.1075~1082 (2011)[DOI]
- Yang K, "Radiation recall dermatitis in response to adjuvant capecitabine immediately following postoperative radiotherapy in a patient with breast cancer", Breast J, 26(5), pp.748~751 (2019)[DOI]
- Shien T, "Adjuvant and neoadjuvant therapy for breast cancer", Jpn J Clin Oncol, 50(3), pp.225~229 (2020)[DOI]
- Haussmann J, "Recent advances in radiotherapy of breast cancer", Radiation Oncology, 15, pp.1~10 (2020)[DOI]
- Zhou L, "Effects of postoperative radiotherapy in early breast cancer patients older than 75 years : A propensity-matched analysis", Journal of Cancer, 10(25), pp.6225~6232 (2019)[DOI]
- Mondal D, "Dual partial arc volumetric-modulated arc therapy : The game changer for accelerated hypofractionated whole-breast radiotherapy with simultaneous integrated tumor cavity boost in early breast cancer-A comparative dosimetric study with single partial arc volumetricmodulated arc therapy", J Cancer Res Ther, 15(5), pp.1005~1010 (2019)[DOI]
- "Radiation therapy induced cardiac toxicity" (2020)[URL]
- Ham IS, "Dosimetric comparison of setup errors in intensity modulated radiation therapy with deep inspiration breath holding in breast cancer radiation therapy", Journal of Radiological Science and Technology, 42(2), pp.137~143 (2019)[DOI]
- Arsene-Henry A, "Evolution of radiation techniques in the treatment of breast cancer(BC)patients : from 3D conformal radiotherapy(3D CRT)to intensity-modulated RT(IMRT)using helical tomotherapy(HT)", Radiotherapy and Oncology, 124, pp.333~334 (2017)[DOI]
- Rossi M, "Contralateral tissue sparing in lymph node-positive breast cancer radiotherapy with VMAT technique", Med Dosim, 44(2), pp.117~121 (2019)[DOI]
- Zhao H, "A comparative dosimetric study of left-sided breast cancer after breast-conserving surgery treated with VMAT and IMRT", Radiat Oncol, 10(1), pp.231~241 (2015)[DOI]
- Huang JH, "Evaluation of fixed-jaw IMRT and tangential partial-VMAT radiotherapy plans for synchronous bilateral breast cancer irradiation based on a dosimetric study", J Appl Clin Med Phys, 20(1), pp.31~41 (2019)[DOI]
- Gregoire V, "State of the art on dose prescription, reporting and recording in intensitymodulated radiation therapy(ICRU report No. 83)", Cancer Radiother, 15, pp.555~559 (2011)[DOI]
- Jin GH, "A comparative dosimetric study for treating left-sided breast cancer for small breast size using five different radiotherapy techniques : Conventional tangential field, filed-in-filed, tangential-IMRT, multi-beam IMRT and VMAT", Radiat Oncol, 8(1), pp.89~97 (2023)[DOI]
- Musa AE, "Radiation-induced heart diseases : Protective effects of natural products", Medicina(Kaunas), 55(4), pp.126~139 (2019)[DOI]
- Darby SC, "Risk of ischemic heart disease in women after radiotherapy for breast cancer", N Engl J Med, 368(11), pp.987~998 (2013)[DOI]