Background
Methods
Patient eligibility
Study design
Dosimetric study
Images acquisition
Contours definition
Structures | Cranial | Caudal | Anterior | Posterior | Lateral | Medial |
---|---|---|---|---|---|---|
Chest wall | Caudal border of the clavicle head | Contralateral inframammary fold | 2 mm below the skin surface | Rib-pleural interface | Mid-axillary line | Sternal-rib junction |
Supra-clavicular | Caudal to the cricoid cartilage | Junction of brachioecph.- axillary veins/caudal edge clavicle head | Posterior edge of SCM muscle | Anterior aspect of the scalene muscle | Cranial: lateral edge of SCM muscle | Excludes thyroid and trachea |
Caudal: junction 1st rib-clavicle | ||||||
Infra-clavicular | Pectoralis minor muscle insert on coracoid | Axillary vessels cross medial edge of pectoralis minor muscle | Posterior surface of pectoralis major muscle | Ribs and intercostal muscles | Medial border of pectoralis minor muscle | Thoracic inlet |
Internal mammary | Superior aspect of the medial 1st rib. | Cranial aspect of the 4th rib | Encompass the internal mammary vessels | Encompass the internal mammary vessels | Encompass the internal mammary vessels | Encompass the internal mammary vessels |
Plan optimization
Plan evaluation
Clinical study
Statistical analysis
Results
Dosimetry data
Delivery parameters
Target coverage and homogeneity
Parameters | Plans | Value (Mean±SD) | P-value |
---|---|---|---|
Dnear-max (Gy) | All | 54.76±0.97 | |
Integrated | 54.57±0.88 |
0.047
| |
Segmented | 55.01±1.05 | ||
Dnear-min (Gy) | All | 47.53±0.63 | |
Integrated | 47.56±0.70 | 0.622 | |
Segmented | 47.48±0.47 | ||
Dmean (Gy) | All | 51.76±0.41 | |
Integrated | 51.68±0.35 |
0.011
| |
Segmented | 51.94±0.47 | ||
V95% | All | 98%±1% | |
Integrated | 98%±1% | 0.193 | |
Segmented | 98%±1% | ||
V107% | All | 9%±6% | |
Integrated | 7%±5% |
0.003
| |
Segmented | 11%±6% | ||
V110% | All | 2%±1% | |
Integrated | 2%±2% |
0.023
| |
Segmented | 3%±2% | ||
HI | All | 0.13±0.02 | |
Integrated | 0.13±0.01 | 0.069 | |
Segmented | 0.14±0.02 | ||
CI | All | 1.43±0.15 | |
Integrated | 1.41±0.14 | 0.053 | |
Segmented | 1.47±0.15 |
OARs and healthy tissue
Organ/Structure | Parameters | Plans | Value (Mean±SD) | P-value |
---|---|---|---|---|
Ipsilateral lung | V5 | All | 65%±8% | |
Integrated | 67%±9% |
0.005
| ||
Segmented | 61%±7% | |||
V20 | All | 28%±2% | ||
Integrated | 28%±3% | 0.980 | ||
Segmented | 28%±2% | |||
Dmean (Gy) | All | 15.06±1.66 | ||
Integrated | 15.11±1.54 | 0.658 | ||
Segmented | 14.93±1.99 | |||
Contralateral lung | V5 | All | 12%±11% | |
Integrated | 14%±12% | 0.157 | ||
Segmented | 9%±8% | |||
Dmean (Gy) | All | 2.26±1.32 | ||
Integrated | 2.58±1.43 |
0.019
| ||
Segmented | 1.66±0.83 | |||
Heart | V5 | Left-sided lesions | 56%±15% | |
Integrated | 60%±13% |
0.001
| ||
Segmented | 45%±13% | |||
V10 | Left-sided lesions | 30%±9% | ||
Integrated | 31%±10% | 0.076 | ||
Segmented | 26%±7% | |||
V20 | Left-sided lesions | 13%±6% | ||
Integrated | 14%±7% | 0.77 | ||
Segmented | 13%±4% | |||
V30 | Left-sided lesions | 7%±3% | ||
Integrated | 8%±4% | 0.21 | ||
Segmented | 6%±3% | |||
Dmean (Gy) | Left-sided lesions | 8.69±1.47 | ||
Integrated | 8.76±1.61 | 0.65 | ||
Segmented | 8.54±1.14 | |||
Spinal cord | Dmax (Gy) | All | 36.10±5.87 | |
Integrated | 37.24±4.55 |
0.009
| ||
Segmented | 33.29±7.97 | |||
Ipsilateral humeral head | Dmean (Gy) | All | 23.98±9.25 | |
Integrated | 28.22±5.60 |
<0.001
| ||
Segmented | 12.31±6.99 | |||
Esophagus | Dnear-max (Gy) | All | 41.56±7.79 | |
Integrated | 41.84±9.15 | 0.85 | ||
Segmented | 41.29±6.47 | |||
Dmean (Gy) | All | 11.14±3.11 | ||
Integrated | 11.22±2.78 | 0.745 | ||
Segmented | 10.83±4.27 | |||
Contralateral breast | Dmean (Gy) | All | 0.98±0.46 | |
Integrated | 1.01±0.48 | 0.418 | ||
Segmented | 0.90±0.43 | |||
V5 | All | 2%±1% | ||
Integrated | 2%±2% | 0.299 | ||
Segmented | 1%±1% | |||
Healthy tissue | EI | All | 0.30±0.04 | |
Integrated | 0.31±0.03 | 0.094 | ||
Segmented | 0.28±0.05 |