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Breast boost vector: a new metric proposed to optimise isocentre location in an fIMRT–VMAT hybrid technique for a simultaneous integrated boost in breast radiotherapy

Published online by Cambridge University Press:  20 April 2020

Víctor de la Llana Open the ORCID record for Víctor de la Llana [Opens in a new window] ,
Ángel del Castillo ,
Carlos Andrés ,
Laura Gómez ,
Manuel Agulla ,
María Luisa del Valle ,
María Iglesias  and
Ricardo Torres
Víctor de la Llana*
Affiliation:
Servicio de Radiofísica y Protección Radiológica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
Ángel del Castillo
Affiliation:
Servicio de Radiofísica y Protección Radiológica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
Carlos Andrés
Affiliation:
Servicio de Radiofísica y Protección Radiológica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
Laura Gómez
Affiliation:
Servicio de Oncología Radioterápica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
Manuel Agulla
Affiliation:
Servicio de Radiofísica y Protección Radiológica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
María Luisa del Valle
Affiliation:
Servicio de Oncología Radioterápica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
María Iglesias
Affiliation:
Servicio de Oncología Radioterápica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
Ricardo Torres
Affiliation:
Servicio de Radiofísica y Protección Radiológica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
*
Author for correspondence: Víctor de la Llana, Servicio de Radiofísica y Protección Radiológica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain. Tel: +34687683864. E-mail: Victor_llg@hotmail.com
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Abstract

Purpose:

Evaluating the improvements of placing the treatment isocentre at the boost centre of mass (CoM) in a hybrid treatment for breast cancer radiotherapy.

Material and methods:

Twenty-two patients were planned in two isocentre locations with two forward intensity-modulated radiation therapy (fIMRT) tangentials to the breast and a volumetric-modulated arc therapy (VMAT) to the boost. A simultaneous integrated boost technique was used. Breast Boost (BB) Vector was investigated as a criterion for selecting an appropriate isocentre placement. Various metrics for boost, breast and hybrid plans were analysed using analysis of variance statistics.

Results:

Comparing hybrid plans at the boost CoM vs. hybrid plans at the breast CoM, no significant differences were found. Analysis of relative variations of planning target volume (PTV) boost coverage vs. BB Vector indicated an upgrade in boost CoM isocentre strategy. Dose to organs at risk was comparable: V5Gy (26·24 vs. 25·69%, p = 0·8), V20Gy (14·66 vs. 14·58%, p = 0·959) and the mean dose (7·37 Gy vs. 7·26 Gy, p = 0·879) to ipsilateral lung; V5Gy (15·60 vs. 15·22%, p = 0·903), and the mean dose (4·91 Gy vs. 4·86 Gy, p = 0·950) to heart and dose to free breast of boost (46·71 Gy vs. 46·62 Gy, p = 0·408).

Findings:

The hybrid fIMRT–VMAT technique centred at the boost CoM resulted equivalent to plans centred at the breast CoM, while benefiting from an enhancement in PTV boost coverage for patients with BB Vector superior to 5.

Keywords

breast radiotherapyhybrid techniqueisocentre positionsimultaneously integrated boostVMAT
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 20 , Issue 2 , June 2021 , pp. 158 - 163
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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