Influence of respiratory movement during post mastectomy radiotherapy on targets and heart for breast cancer

Asia Pac J Clin Oncol. 2023 Apr;19(2):e54-e59. doi: 10.1111/ajco.13773. Epub 2022 Jun 2.

Abstract

Background/aim: This study aimed to compare the dosimetric consequences of respiratory movement in volumetric-modulated arc therapy (VMAT) and three-dimensional conformal radiation therapy (3D-CRT) during postmastectomy radiation therapy, including internal mammary nodes (IMNs).

Materials and methods: Respiratory motion was implemented to a phantom using a dynamic device. The plans were delivered during cranial-caudal and ventral-dorsal movement in 5-mm (R05) and 10-mm (R10) amplitudes.

Results: At the IMN, the dose errors were -2.8% (R05) and -6.2% (R10) for 3D-CRT and -4.9% (R05) and -8.5% (R10) for VMAT. The dose errors in chest wall were -.5% (R05) and -6.0% (R10) for 3D-CRT and -1.9% (R05) and -5.3% (R10) for VMAT. The left anterior descending doses showed significantly small absolute values. The gamma pass rates of VMAT were higher than those of 3D-CRT.

Conclusions: The benefit of VMAT technique in dose distribution was maintained, except in occasional instances of large breathing motion.

Keywords: breast neoplasm; internal mammary nodes; mastectomy; radiation therapy; respiration.

MeSH terms

  • Breast Neoplasms* / radiotherapy
  • Breast Neoplasms* / surgery
  • Female
  • Humans
  • Mastectomy
  • Radiotherapy Dosage
  • Radiotherapy Planning, Computer-Assisted / methods
  • Radiotherapy, Conformal* / methods