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Mono versus dual isocentric technique for breast cancer radiotherapy: evaluation of planning, dosimetry and treatment delivery

Published online by Cambridge University Press:  23 September 2020

Tabassum Wadasadawala Open the ORCID record for Tabassum Wadasadawala [Opens in a new window] ,
Shirley Lewis ,
Utpal Gaikwad ,
Umesh Gayake ,
Reena Phurailatpam ,
Santosh Tambe  and
Rajiv Sarin
Tabassum Wadasadawala*
Affiliation:
Department of Radiation Oncology, Tata Memorial Centre, ACTREC, Homi Bhabha National Institute, Navi Mumbai, India
Shirley Lewis
Affiliation:
Department of Radiotherapy and Oncology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
Utpal Gaikwad
Affiliation:
Department of Radiation Oncology, Tata Memorial Centre, ACTREC, Homi Bhabha National Institute, Navi Mumbai, India
Umesh Gayake
Affiliation:
Department of Radiation Oncology, Tata Memorial Centre, ACTREC, Homi Bhabha National Institute, Navi Mumbai, India
Reena Phurailatpam
Affiliation:
Department of Radiation Oncology, Tata Memorial Centre, ACTREC, Homi Bhabha National Institute, Navi Mumbai, India
Santosh Tambe
Affiliation:
Department of Radiation Oncology, Tata Memorial Centre, ACTREC, Homi Bhabha National Institute, Navi Mumbai, India
Rajiv Sarin
Affiliation:
Department of Radiation Oncology, Tata Memorial Centre, ACTREC, Homi Bhabha National Institute, Navi Mumbai, India
*
Address for Correspondence: Dr Tabassum Wadasadawala, MD, DNB, Professor (Radiation Oncology), Advanced Center for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, CISF Road, Near Central Park, Kharghar, Navi Mumbai, India-410210; Phone: +91-22-27405079; Fax: +91-22-27405061. E-mail: twadasadawala@actrec.gov.in; drtabassum2004@rediffmail.com
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Abstract

Aim:

To compare the dosimetry and reproducibility of set-up with monoisocentric technique (MIT) and dual isocentric technique (DIT) in adjuvant breast radiotherapy (RT).

Material and methods:

Breast cancer patients treated with MIT or DIT were retrospectively studied. The organ-at-risk dose was compared between two groups. All patients underwent set-up verification with an electronic portal imaging device, and set-up time was recorded for each fraction. Treatment reproducibility was assessed in terms of systematic and random error.

Results:

Twenty patients were included (11 right and 9 left-sided tumours) and ten received whole breast RT, while the rest received chest wall RT. Overall, the mean heart dose was less with MIT (0.40 versus 0.79, p = <0.001) as well as in left-sided tumours (0.37 versus 0.98, p = 0.003). The maximum dose at the field junction was significantly higher with DIT (43 Gy, 107%, p = 0.003). The maximum total error was 1 cm in lateral for supraclavicular field and 8 mm in superior–inferior in tangents for both techniques. There was no difference in set-up errors between the two techniques.

Findings:

MIT resulted in better dose homogeneity at the field junctions and reduced mean heart dose as compared to DIT. MIT is safe for implementation in clinical practice for breast cancer treatment.

Conclusion:

This study is one of the few studies comparing MIT with DIT in terms of the dosimetry and the first one to compare set-up errors between the two techniques. The ease of set-up and better dosimetry with MIT was achieved.

Keywords

breast cancerdual isocentricmonoisocentricradiotherapyreproducibility
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 1 , March 2022 , pp. 1 - 6
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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