PMID- 28988893
OWN - NLM
STAT- MEDLINE
DCOM- 20180830
LR  - 20180830
IS  - 1873-4022 (Electronic)
IS  - 1873-4022 (Linking)
VI  - 43
IP  - 1
DP  - 2018 Spring
TI  - Radiation therapy of synchronous bilateral breast carcinoma (SBBC) using multiple 
      techniques.
PG  - 55-68
LID - S0958-3947(17)30094-8 [pii]
LID - 10.1016/j.meddos.2017.08.003 [doi]
AB  - The purpose of this study was to establish intensity-modulated radiation therapy 
      (IMRT) and volumetric-modulated arc therapy (VMAT) treatment plans for 
      synchronous bilateral breast cancer (SBBC) and to compare those plans with the 
      previous treatment plans using 3D conformal radiation therapy (3DCRT). The 
      differences among the treatments were also statistically compared regarding 
      dosimetry distribution and treatment efficiency. The research was conducted with 
      10 SBBC patients. The study established IMRT (12 fields with a single isocenter) 
      and VMAT (2 partial arcs with a single isocenter) treatment plans for SBBC 
      patients and then compared those plans with 3DCRT (8 fields with multiple 
      isocenters). The plans were evaluated based on a dose-volume histogram analysis. 
      For planning target volumes (PTVs), the mean doses and the values of V(95%), 
      V(105%), conformity index, and homogeneity index were reported. For the organs at 
      risk, the analysis included the mean dose, maximum dose, and V(XGy), depending on 
      the organs (lungs, heart, and liver). To objectively evaluate the efficiency of 
      the treatment plans, each plan's beam times, treatment times (including set-up 
      time), and monitor units were compared. Tukey test and one-way analysis of 
      variance were used to compare the PTV and organs at risk values of the 3 
      techniques. Additionally, the independent-samples t-test was used to compare the 
      2 techniques (IMRT and VMAT) based on the values of Rt. PTV and Lt. PTV 
      (p < 0.05). For PTV dose distribution, IMRT showed increases of approximately 
      1.2% in D(mean) and of approximately 5.7% in V(95%) dose distribution compared 
      with 3DCRT. In comparison to VMAT, 3DCRT showed about 3.0% higher dose 
      distribution in D(mean) and V(95%). IMRT was the best in terms of conformity 
      index and homogeneity index (p < 0.05), whereas 3DCRT and VMAT did not 
      significantly differ from each other. In terms of dose distribution on lungs, 
      heart, and liver, the percentage of volume at high doses such as V(30Gy) and 
      V(40Gy) was approximately 70% lower for IMRT and approximately 40% lower for VMAT 
      than for 3DCRT. For distribution volumes of low doses such as V(5%) and V(10%), 
      that for 3DCRT was approximately 60% smaller than for IMRT and approximately 70% 
      smaller than for VMAT. Comparison between IMRT and VMAT showed that the IMRT was 
      superior in all distribution factors. VMAT showed better treatment efficiency 
      than 3DCRT or IMRT. Among the SBBC radiotherapy treatment plans, IMRT was 
      superior to 3DCRT and VMAT in terms of PTV dose distribution, whereas VMAT showed 
      the most outstanding treatment efficiency.
CI  - Copyright (c) 2017 American Association of Medical Dosimetrists. Published by 
      Elsevier Inc. All rights reserved.
FAU - Kim, Sung Jin
AU  - Kim SJ
AD  - Department of Radiation Oncology, Eulji University Hospital, Eulji University, 
      College of Medicine, Daejeon, Republic of Korea; Department of Physics, Yeung Nam 
      University, Daegu, Republic of Korea.
FAU - Lee, Mi Jo
AU  - Lee MJ
AD  - Department of Radiation Oncology, Eulji University Hospital, Eulji University, 
      College of Medicine, Daejeon, Republic of Korea.
FAU - Youn, Seon Min
AU  - Youn SM
AD  - Department of Radiation Oncology, Eulji University Hospital, Eulji University, 
      College of Medicine, Daejeon, Republic of Korea. Electronic address: 
      smyoun@eulji.ac.kr.
LA  - eng
PT  - Journal Article
DEP - 20171005
PL  - United States
TA  - Med Dosim
JT  - Medical dosimetry : official journal of the American Association of Medical 
      Dosimetrists
JID - 8908862
SB  - IM
MH  - Breast Neoplasms/*radiotherapy
MH  - Female
MH  - Heart/radiation effects
MH  - Humans
MH  - Liver/radiation effects
MH  - Lung/radiation effects
MH  - Neoplasms, Multiple Primary/*radiotherapy
MH  - Organs at Risk
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/*methods
MH  - Radiotherapy, Intensity-Modulated/adverse effects/*methods
OTO - NOTNLM
OT  - 3DCRT
OT  - IMRT
OT  - Synchronous bilateral breast cancer
OT  - VMAT
EDAT- 2017/10/11 06:00
MHDA- 2018/08/31 06:00
CRDT- 2017/10/10 06:00
PHST- 2016/08/09 00:00 [received]
PHST- 2017/07/22 00:00 [revised]
PHST- 2017/08/18 00:00 [accepted]
PHST- 2017/10/11 06:00 [pubmed]
PHST- 2018/08/31 06:00 [medline]
PHST- 2017/10/10 06:00 [entrez]
AID - S0958-3947(17)30094-8 [pii]
AID - 10.1016/j.meddos.2017.08.003 [doi]
PST - ppublish
SO  - Med Dosim. 2018 Spring;43(1):55-68. doi: 10.1016/j.meddos.2017.08.003. Epub 2017 
      Oct 5.