Original Research

Comparison of 3D-conformal and intensity-modulated radiation therapy for left-sided breast cancer

Hesta Friedrich-Nel, Deirdré Long, Nape M. Phahlamohlaka
South African Journal of Oncology | Vol 7 | a262 | DOI: https://doi.org/10.4102/sajo.v7i0.262 | © 2023 Hesta Friedrich-Nel, Deirdré Long, Nape M. Phahlamohlaka | This work is licensed under CC Attribution 4.0
Submitted: 09 December 2022 | Published: 09 June 2023

About the author(s)

Hesta Friedrich-Nel, Department of Clinical Sciences, Faculty of Health and Environmental Sciences, Central University of Technology, Free State, Bloemfontein, South Africa
Deirdré Long, Department of Radiation Oncology, Universitas Annex Hospital, Bloemfontein, South Africa
Nape M. Phahlamohlaka, Department of Clinical Sciences, Faculty of Health and Environmental Sciences, Central University of Technology, Free State, Bloemfontein, South Africa

Abstract

Background: We compared 3D-conformal radiation therapy (3D-CRT) and intensity-modulated radiation therapy (IMRT) planning for left-sided post-mastectomy patients.

Aim: To compare the dose coverage of the planning target volume (PTV) and dose delivered to organs at risk (OAR) of 3D-CRT and IMRT plans.

Setting: Department of Oncology, central South Africa.

Methods: Twenty-six archived CT scans of patients with left-sided breast cancer were included. The 3D-CRT and IMRT plans were designed for each patient and compared using the Monaco© planning system (version 5.11.02). Statistical analysis was performed for PTV coverage (V95%, V98%, V105%) and radiation doses to the heart, ipsilateral lung, combined lungs, contralateral breast, and oesophagus.

Results: The V98% and V105% target volume dose coverage for the 3D-CRT plans were 67.07% and 0.21%, respectively, compared to 92.32% and 1.10% of the IMRT plans. However, the IMRT plans’ mean volume of PTV, receiving 95% of the prescribed dose (PD), was 7.68% compared to the 3D-CRT’s 32.93%. The IMRT plans resulted in a V22 Gy < 10% for the heart, with a value of 4.15%. The V18.87 Gy < 45% values for the ipsilateral and combined lungs were 28.09% and 13.70%, respectively. The 3D-CRT plans showed a lower dose to the oesophagus (5.07 Gy) and contralateral breast (V5 Gy < 15% = 3.51%).

Conclusion: It was shown that 3D-CRT and IMRT treatment planning can effectively achieve clinical goals for post-mastectomy left-sided breast cancer radiotherapy.

Contribution: The findings underscore the continuing relevance of 3D-CRT planning in oncology for optimal PTV dose coverage and low OAR dose.


Keywords

breast cancer; dosimetry; three-dimensional conformal radiation therapy; intensity-modulated radiation therapy; organs at risk

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