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Dosimetric Analysis of Three Different Radiotherapy Techniques in Patients with Breast Cancer and Their Impact on Organs at Risk (OAR)

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2018年第2期7卷 131-140页

作者： Vikas Jagtap dimpal saikia Shashi Bhushan Sharma Shayori Bhattacharjee Moirangthem Nara Singh Sachindra Goswami Apurba Kumar Kalita Department of Radiation Oncology North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences Shillong India Department of Radiation Oncology Cancer Hospital Gauhati Medical College Guwahati India Department of Radiation Oncology & Medical Physics Dr. B Borooah Cancer Institute Guwahati India Department of Radiation Oncology American Oncology Institute Nagpur India

Aim: Dosimetric analysis of three different Radiotherapy techniques in patients with Breast Cancer and their impact on OAR’s. Materials and Methods: 12 patients of Carcinoma Breast who received breast radiotherapy were selected for analysis. Computed tomography (CT) simulation image data sets were retrieved. Planning target Volume (PTV), heart and ipsilateral lung were contoured for planning and analysis of doses. Three different plans using conventional bi-tangential fields were prepared, Plan 1 with SAD full beam with wedge (SAD-FBW), Plan 2 with SSD half beam with wedge (SSD-HBW) and plan 3 with SSD half beam without wedge techniques (SSD-HBO) in CMS Xio TPS. Statistical analysis was done using SPSS version 16.0. Results: The PTV coverage was significantly better in SAD-FBW techniques when compared with the other two techniques i.e. SSD-HBW (mean = 92.33, SD = 4.69, p = 0.005) and SSD-HBO (mean = 75.05, SD = 11.92, p = 0.002). The mean heart doses were significantly better in SAD-FBW compared to SSD-HBW (mean = 3.75, SD = 2.27, p = 0.017) but in SSD-HBO technique mean heart doses were better than SAD-FBW technique (mean = 3.27, SD = 1.94, p = 0.004). Similarly, the left lung V20 values were significantly better in SSD-HBO technique than SAD-FBW technique (mean = 11.75, SD = 4.34, p = 0.004) but there was statistically insignificant difference between the SAD-FBW and SSD-HBW techniques. The treatment monitor units were significantly less in SAD-FBW compared to SSD-HBW but SSD-HBO has less MU compared to SAD-FBW technique. Conclusion: SAD Full Beam with wedge technique is practically better than SSD Half Beam technique with or without wedge without compromising PTV coverage considering other dosimetric parameters. We also recommend that centers treating patient with half beam SSD techniques should shift immediately to SAD techniques.

关键词： Breast Radiotherapy Dosimetric Analysis Breast Cancer

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