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Strahlentherapie und Onkologie

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01.05.2013 | Original article

Node-positive left-sided breast cancer: does VMAT improve treatment plan quality with respect to IMRT?

verfasst von: M. Pasler, D. Georg, S. Bartelt, J. Lutterbach

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 5/2013

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Abstract

Purpose

The aim of the present work was to explore plan quality and dosimetric accuracy of intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) for lymph node-positive left-sided breast cancer.

Methods

VMAT and IMRT plans were generated with the Pinnacle³ V9.0 treatment planning system for 10 lymph node-positive left-sided breast cancer patients. VMAT plans were created using a single arc and IMRT was performed with 4 beams using 6, 10, and 15 MV photon energy, respectively. Plans were evaluated both manually and automatically using ArtiView™. Dosimetric plan verification was performed with a 2D ionization chamber array placed in a full scatter phantom.

Results

Photon energy had no significant influence on plan quality for both VMAT and IMRT. Large variability in low doses to the heart was found due to patient anatomy (range V_5 Gy 26.5–95 %). Slightly more normal tissue dose was found for VMAT (e.g., V_Tissue30% = 22 %) than in IMRT (V_Tissue30% = 18 %). The manual and ArtiView™ plan evaluation coincided very accurately for most dose metrics (difference < 1 %). In VMAT, 96.7 % of detector points passed the 3 %/3 mm gamma criterion; marginally better accuracy was found in IMRT (98.3 %).

Conclusion

VMAT for node-positive left-sided breast cancer retains target homogeneity and coverage when compared to IMRT and allows maximum doses to organs at risk to be reduced. ArtiView™ enables fast and accurate plan evaluation.

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Titel: Node-positive left-sided breast cancer: does VMAT improve treatment plan quality with respect to IMRT?
verfasst von: M. Pasler
D. Georg
S. Bartelt
J. Lutterbach
Publikationsdatum: 01.05.2013
Verlag: Springer-Verlag
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 5/2013
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-012-0281-2

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