A treatment planning comparison of contemporary photon-based radiation techniques for breast cancer.
Zeverino M., Petersson K., Kyroudi A., Jeanneret-Sozzi W., Bourhis J., Bochud F., Moeckli R.
BACKGROUND AND PURPOSE: Adjuvant radiation therapy (RT) of the whole breast (WB) is still the standard treatment for early breast cancer. A variety of radiation techniques is currently available according to different delivery strategies. This study aims to provide a comparison of six treatment planning strategies commonly adopted for breast-conserving adjuvant RT and to use the Pareto concept in an attempt to assess the degree of plan optimization. MATERIALS AND METHODS: Two groups of six left- and five right-sided cases with different dose prescriptions were involved (22 patients in total). Field-in-Field (FiF), two and four Fields static-IMRT (sIMRT-2f and sIMRT-4f), Volumetric-Modulated-Arc-Therapy (VMAT), Helical Tomotherapy (HT) and Static-Angles Tomotherapy (TomoDirect™ - TD) were planned. Dose volume constraints were taken from the RTOG protocol 1005. Pareto fronts were built for a selected case to evaluate the reliability of the plan optimization process. RESULTS: The best target dose coverage was observed for TD able to improve significantly (p