Bilateral lumpectomy for bilateral breast cancer, comparative study between adjuvant 3DCRT and VMAT radiotherapy
DOI:
https://doi.org/10.22317/jcms.v11i5.2038Keywords:
Breast Neoplasms, Radiotherapy, Intensity-Modulated, Radiotherapy, Conformal, Radiotherapy Planning, Computer-Assisted, Mastectomy, SegmentalAbstract
Objective: This study aimed to assess the treatment methods and results linked to adjuvant three-dimensional conformal radiation therapy (3DCRT) compared to volumetric modulated arc therapy (VMAT) radiotherapy following bilateral lumpectomy for breast cancer.
Methods: This prospective comparative study involved 22 female patients diagnosed with bilateral breast cancer, all of whom underwent bilateral lumpectomy. Treatment planning was performed using the MONACO version 5.1 treatment planning system (TPS), employing X-ray photon beams with energies of either 6 MV or 10 MV. Radiotherapy was delivered using the ELEKTA Agility linear accelerator. A total prescribed dose of 4005 cGy was administered over 15 fractions.
Results: The study compares the performance of volumetric modulated arc therapy (VMAT) and three-dimensional conformal radiation therapy (3DCRT) in various parameters. VMAT shows better dose coverage for planning target volumes (PTVs) and regions of elevated radiation (V105% and V110%). However, 3DCRT shows slightly higher efficacy for the left planning target volume, particularly in the V90% metric. VMAT also shows superior performance in terms of homogeneity and conformity for the target volume. However, there is a significant difference in the left PTV, but no significant difference is found in the right PTV. The results suggest that 3D treatment planning is more effective in reducing the average dose to the heart and left and right lungs compared to VMAT. The discrepancy in average lung dosage between the left and right sides is less prominent in 3DCRT compared to VMAT.
Conclusion: The study reveals that volumetric modulated arc therapy (VMAT) offers better dose coverage for planned target volumes in bilateral lumpectomy for breast cancer. At the same time, 3DCRT minimises radiation exposure to the left PTV. VMAT has better homogeneity and conformity indexes for acceptable goal volumes.
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