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Evaluation on dosimetric plan quality and treatment delivery time of dynamic jaw mode in TomoTherapy® for left-side breast cancer patients

Published online by Cambridge University Press:  11 October 2021

Sin Ting Chiu Open the ORCID record for Sin Ting Chiu [Opens in a new window] ,
Po Man Wu ,
Ka Fai Cheng ,
Pui Hei Fok  and
George Chiu
Sin Ting Chiu*
Affiliation:
Department of Radiotherapy, Hong Kong Sanatorium & Hospital, Hong Kong, China
Po Man Wu
Affiliation:
Department of Medical Physics and Research, Hong Kong Sanatorium & Hospital, Hong Kong, China
Ka Fai Cheng
Affiliation:
Department of Radiotherapy, Hong Kong Sanatorium & Hospital, Hong Kong, China
Pui Hei Fok
Affiliation:
Department of Radiotherapy, Hong Kong Sanatorium & Hospital, Hong Kong, China
George Chiu
Affiliation:
Department of Radiotherapy, Hong Kong Sanatorium & Hospital, Hong Kong, China
*
Author for correspondence: Sin Ting Chiu, Department of Radiotherapy, G/F, Li Shu Pui Block, Hong Kong Sanatorium & Hospital, 2 Village Road, Happy Valley, Hong Kong, China. Tel: (852) 2835 8916 E-mail: sinting.chiu@hksh.com
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Abstract

Background:

Few studies claimed that dynamic jaw (DJ) mode in Helical TomoTherapy® (HT) could improve the cranio-caudal dose distribution without prolonging the treatment time in treating different types of cancer. Also, studies suggested that DJ with a wider 5 cm field width (FW) could replace fixed jaws (FJ) with 2.5 cm FW to reduce the delivery time with the sustainable plan quality. Yet, the study on breast cancer with supraclavicular fossa (SCF) nodal involvement using DJ mode in HT is limited. This study aims to evaluate the DJ mode retrospectively by comparing their dosimetric quality with normal tissue complication probability (NTCP) of organs at risk and treatment delivery time with FJ mode on treating left-side breast with SCF nodal involvement.

Materials and methods:

All post-mastectomy patients, who had been irradiated for left-side breast with SCF nodal involvement were selected retrospectively in this study. With the same dose constraint and prescription as the treated DJ2.5 plan, two extra plans using DJ mode with 5 cm FW(DJ5.0) and FJ mode with 2.5 cm FW (FJ2.5) were computed for plan comparison.

Results:

No statistical significance was found in all the parameters of PTV and OARs, except for V20 of whole lung. DJ5.0 received V20 in ipsilateral left lung than FJ2.5 and DJ2.5. However, the average delivery time of DJ5.0 was significantly lower than that of DJ2.5 and FJ2.5 by almost 40%.

Conclusions:

No statistical significance was found in those dosimetric and radiobiological parameters among three modes while the delivery time has greatly reduced by using DJ5.0. A shorter treatment time can minimise intra-fractional error and better the patient’s experience during treatment.

Keywords

breast cancerdynamic jaw modesupraclavicular fossa (SCF) nodal involvementTomotherapytreatment planning
Type
Technical Note
Information
Journal of Radiotherapy in Practice , Volume 22 , 2023 , e16
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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