Dosimetric Comparison of Tangential Beam and Equally Spaced Beam Intensity-modulated Radiation Therapy in Right Breast Cancer Following Breast-conserving Surgery: A Retrospective Study

乳房保留手术后右侧乳腺癌切线束与等间距束调强放射治疗剂量学比较:一项回顾性研究

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Abstract

OBJECTIVE: This study aimed to evaluate and compare the dosimetric performance and treatment efficiency of two intensity-modulated radiation therapy (IMRT) techniques - tangential field IMRT (Tan_IMRT) and equally spaced beam IMRT (Esb_IMRT) - in patients with right-sided breast cancer following breast-conserving surgery (BCS). MATERIALS AND METHODS: A total of 25 female patients who underwent BCS for right-sided breast cancer and received adjuvant radiotherapy were included in this retrospective study. All patients were treated with whole-breast hypofractionated radiotherapy, delivering 40.05 Gy in 15 fractions. Each patient's treatment plans were generated using the Eclipse Treatment Planning System, employing Tan_IMRT and Esb_IMRT techniques on a TrueBeam SVC linear accelerator equipped with a high-definition multileaf collimator. Various dosimetric parameters were evaluated, including the conformity index (CI), homogeneity index (HI), dose-volume histogram metrics for organs at risk, and monitor units (MUs). RESULTS: In right-sided breast radiotherapy following BCS, Esb_IMRT demonstrated a superior CI and HI compared to Tan_IMRT. In addition, Esb_IMRT achieved lower ipsilateral lung doses, as reflected by reduced V20%, V5%, and mean dose (D(mean)). However, Tan_IMRT resulted in a lower D(mean) for the contralateral breast. CONCLUSION: Tan_IMRT shows reduced radiation exposure to the heart, contralateral lung, and contralateral breast. Furthermore, Tan_IMRT delivers doses with fewer MUs. In contrast, Esb_IMRT gives superior CI and HI while achieving lower doses to the ipsilateral lung and liver. Hence, Tan_IMRT can be suitable for younger patients.

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