PMID- 33953498
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 0971-6203 (Print)
IS  - 1998-3913 (Electronic)
IS  - 0971-6203 (Linking)
VI  - 45
IP  - 4
DP  - 2020 Oct-Dec
TI  - Is Synchronous Bilateral Breast Irradiation Using Flattening Filter-Free 
      Beam-Based Volumetric-Modulated Arc Therapy Beneficial? A Dosimetric Study.
PG  - 226-233
LID - 10.4103/jmp.JMP_32_20 [doi]
AB  - OBJECTIVE: The aim of this study is to validate the clinical use of flattening 
      filter-free (FFF) beam-based volumetric-modulated arc therapy (VMAT) in 
      synchronous bilateral breast carcinoma (SBBC) patient treatments and to compare 
      with flattening filtered (FF) beam-based VMAT. MATERIALS AND METHODS: Computed 
      tomography images of 15 SBBC patients were taken for this study. A dose of 50 Gy 
      in 25 fractions was prescribed to planning target volume (PTV). VMAT plans were 
      generated using both FFF and FF 6 MV X-ray beams in Eclipse treatment planning 
      system. PTV and organs at risk (OARs) doses were analyzed quantitatively using 
      dose-volume histograms (DVHs) to meet plan objectives. Pretreatment point and 
      planar dosimetry were performed. RESULTS: The findings were reported as mean +/- 1 
      standard deviation. PTV volume receiving 95% of the prescribed dose was 95.71% +/- 
      0.65% for FF-VMAT and 95.45% +/- 1.33% for FFF-VMAT (P = 0.743). Conformity index 
      was 1.12 +/- 0.31 (FF-VMAT) and 1.12 +/- 0.02 (FFF-VMAT). Right lung mean dose was 
      10.95 +/- 1.33 Gy (FF-VMAT) and 10.60 +/- 98.5 (FFF-VMAT). Left lung mean dose was 
      9.73 +/- 1.56 (FF-VMAT) and 9.61 +/- 1.53 Gy (FFF-VMAT). Tumor control probability 
      (TCP) was 99.68% +/- 0.02% (FF-VMAT) and 99.67% +/- 0.01% (FFF-VMAT) (P = 0.390). 
      Uncomplicated TCP was 98.72% +/- 0.02% (FF-VMAT) and 98.72% +/- 0.01% (FFF-VMAT) (P = 
      0.508). CONCLUSION: The planning objective parameters achieved using FFF-based 
      VMAT showed that FFF can also be used clinically to treat bilateral breast 
      carcinomas and the low-dose lung volumes were still lesser with FFF-VMAT plans 
      than FF-VMAT.
CI  - Copyright: (c) 2021 Journal of Medical Physics.
FAU - Nagaraj, Jagadheeskumar
AU  - Nagaraj J
AD  - Department of Physics, School of Advanced Science, Vellore Institute of 
      Technology, Vellore, Tamil Nadu, India.
AD  - Department of Radiation Oncology, Yashoda Hospitals, Hyderabad, Telangana, India.
FAU - Veluraja, K
AU  - Veluraja K
AD  - Department of Physics, School of Advanced Science, Vellore Institute of 
      Technology, Vellore, Tamil Nadu, India.
LA  - eng
PT  - Journal Article
DEP - 20210202
PL  - India
TA  - J Med Phys
JT  - Journal of medical physics
JID - 9441104
PMC - PMC8074717
OTO - NOTNLM
OT  - Bilateral breast
OT  - SBBC
OT  - breast radiotherapy
OT  - flattening filter free
OT  - synchronous bilateral breast
OT  - volumetric-modulated arc therapy
COIS- There are no conflicts of interest.
EDAT- 2021/05/07 06:00
MHDA- 2021/05/07 06:01
PMCR- 2020/10/01
CRDT- 2021/05/06 06:59
PHST- 2020/05/02 00:00 [received]
PHST- 2020/10/23 00:00 [revised]
PHST- 2020/10/29 00:00 [accepted]
PHST- 2021/05/06 06:59 [entrez]
PHST- 2021/05/07 06:00 [pubmed]
PHST- 2021/05/07 06:01 [medline]
PHST- 2020/10/01 00:00 [pmc-release]
AID - JMP-45-226 [pii]
AID - 10.4103/jmp.JMP_32_20 [doi]
PST - ppublish
SO  - J Med Phys. 2020 Oct-Dec;45(4):226-233. doi: 10.4103/jmp.JMP_32_20. Epub 2021 Feb 
      2.