Synchronous bilateral breast carcinoma irradiation: A comparative investigation between flattened and unflattened beams

Song Duan; Chengwen Li; Juntian Shi; Yujia Ma; Xingxing Zhang; Jianghua Huang; Xiuxiu Wu; Xiao Lin; Xiaobo Huang

doi:10.1016/j.apradiso.2021.110079

Synchronous bilateral breast carcinoma irradiation: A comparative investigation between flattened and unflattened beams

Appl Radiat Isot. 2022 Mar:181:110079. doi: 10.1016/j.apradiso.2021.110079. Epub 2022 Jan 5.

Authors

Song Duan¹, Chengwen Li¹, Juntian Shi¹, Yujia Ma¹, Xingxing Zhang¹, Jianghua Huang¹, Xiuxiu Wu¹, Xiao Lin², Xiaobo Huang³

Affiliations

¹ Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Department of Radiation Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
² Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Department of Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
³ Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Department of Radiation Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Department of Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China. Electronic address: huangxbo@mail.sysu.edu.cn.

PMID: 35016153
DOI: 10.1016/j.apradiso.2021.110079

Abstract

Synchronous bilateral breast carcinoma (SBBC) radiotherapy is a very complicated and time-consuming process. Considering the advantages of unflattened (FFF) beams at a high dose rate, this work investigated the feasibility of FFF beam application in SBBC radiotherapy and compared the advantages between FFF and flattened (FF) beams. CT images of 13 patients with SBBC were retrospectively collected to design intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) plans using FF and FFF beams. Dosimetric verification was applied for each plan. The target volume metrics, dose received by organs at risk (OARs), and delivery parameter of the plans were documented. All plans met the universal tolerance limits in dosimetric verification. FFF decreased the volume to receive 5 Gy (V_5Gy), V_7Gy, and mean dose of the left lung but slightly increased the V_30Gy of the liver for VMAT and decreased the V_17Gy and V_20Gy of the right lung for IMRT. No remarkable differences between FF and FFF were found in the other investigated OARs and all the investigated target volume metrics. The mean treatment times of FFF were 66 and 45 s shorter than those of FF for IMRT and VMAT, respectively. FFF beams were feasible and had advantages in reducing treatment time and protecting the lung while maintaining the target volume metrics in SBBC irradiation.

Keywords: Organs at risk; Synchronous bilateral breast carcinoma radiotherapy; Target volume metrics; Treatment time; Unflattened beams.

Publication types

Comparative Study

MeSH terms

Adult
Aged
Breast Neoplasms / radiotherapy*
Female
Humans
Middle Aged
Organs at Risk / radiation effects
Radiation Tolerance
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted / methods*
Radiotherapy, Intensity-Modulated / methods*
Retrospective Studies