Retrospective Analysis for Dose Reduction to Organs at Risk with New Personalized Breast Holder (PERSBRA) in Left Breast IMRT

Chiu-Ping Chen; Tung-Ho Chen; Jeng-Fong Chiou; Yi-Ju Chen; Chia-Chun Kuo; Kuo-Hsiung Tseng; Meng-Yun Chung; Chun-You Chen; Jeng-You Wu; Long-Sheng Lu; Shih-Ming Hsu

doi:10.3390/jpm12091368

Retrospective Analysis for Dose Reduction to Organs at Risk with New Personalized Breast Holder (PERSBRA) in Left Breast IMRT

J Pers Med. 2022 Aug 25;12(9):1368. doi: 10.3390/jpm12091368.

Authors

Chiu-Ping Chen^{1

2

3}, Tung-Ho Chen⁴, Jeng-Fong Chiou^{4

5}, Yi-Ju Chen¹, Chia-Chun Kuo^{1

4

6

7}, Kuo-Hsiung Tseng⁸, Meng-Yun Chung⁸, Chun-You Chen^{1

9}, Jeng-You Wu^{1

10}, Long-Sheng Lu^{4

11

12

13

14}, Shih-Ming Hsu^{2

3}

Affiliations

¹ Department of Radiation Oncology, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan.
² Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei 112, Taiwan.
³ Medical Physics and Radiation Measurements Laboratory, National Yang Ming Chiao Tung University, Taipei 112, Taiwan.
⁴ Department of Radiation Oncology, Taipei Medical University Hospital, Taipei Medical University, Taipei 110, Taiwan.
⁵ Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
⁶ School of Health Care Administration, College of Management, Taipei Medical University, Taipei 110, Taiwan.
⁷ Program for Cancer Molecular Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University and Academia Sinica, Taipei 110, Taiwan.
⁸ Department of Electrical Engineering, National Taipei University of Technology, Taipei 106, Taiwan.
⁹ Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 110, Taiwan.
¹⁰ Graduate Institute of Data Science, Taipei Medical University, Taipei 110, Taiwan.
¹¹ Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110, Taiwan.
¹² TMU Research Center of Cancer Translational Medicine, Taipei Medical University, Taipei 110, Taiwan.
¹³ International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110, Taiwan.
¹⁴ International Ph.D. Program for Cell Therapy and Regenerative Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.

Abstract

This study evaluated dose differences in normal organs at risk, such as the lungs, heart, left anterior descending artery (LAD), right coronary artery, left ventricle, and right breast under personalized breast holder (PERSBRA), when using intensity-modulated radiation therapy (IMRT). This study evaluated the radiation protection offered by PERSBRA in left breast cancer radiation therapy. Here, we retrospectively collected data from 24 patients with left breast cancer who underwent breast-conserving surgery as well as IMRT radiotherapy. We compared the dose differences in target coverage and organs at risk with and without PERSBRA. For target coverage, tumor prescribed dose 95% coverage, conformity index, and homogeneity index were evaluated. For organs at risk, we compared the mean heart dose, mean left ventricle dose, LAD maximum and mean dose, mean left lung receiving 20 Gy, 10 Gy, and 5 Gy of left lung volume, maximum and mean coronary artery of the right, maximum of right breast, and mean dose. Good target coverage was achieved with and without PERSBRA. When PERSBRA was used with IMRT, the mean dose of the heart decreased by 42%, the maximum dose of LAD decreased by 26.4%, and the mean dose of LAD decreased by 47.0%. The mean dose of the left ventricle decreased by 54.1%, the volume (V₂₀) of the left lung that received 20 Gy decreased by 22.8%, the volume (V₁₀) of the left lung that received 10 Gy decreased by 19.8%, the volume (V₅) of the left lung that received 5 Gy decreased by 15.7%, and the mean dose of the left lung decreased by 23.3%. Using PERSBRA with IMRT greatly decreases the dose to organs at risk (left lung, heart, left ventricle, and LAD). This study found that PERSBRA with IMRT can achieve results similar to deep inspiration breath-hold radiotherapy (DIBH) in terms of reducing the heart radiation dose and the risk of developing heart disease in patients with left breast cancer who cannot undergo DIBH.

Keywords: breast cancer; intensity-modulated radiation therapy; organs at risk; personalized breast holder.

Abstract

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