| He Xiantao,Long Yusong,Tan Junwen,Li Gang,Feng Yongfu,Yang Hui,Lu Ying,Wang Zhanyu.Application of helical tomotherapy in the treatment of synchronous bilateral breast cancer[J].Chinese Journal of Radiological Medicine and Protection,2022,42(12):943-949 |
| Application of helical tomotherapy in the treatment of synchronous bilateral breast cancer |
| Received:September 19, 2022 |
| DOI：10.3760/cma.j.cn112271-20220919-00377 |
| KeyWords:Bilateral breast neoplasms|Radiotherapy|Helical tomotherapy|Volumetric modulated arc therapy|Dosimetry |
| FundProject:广西重点研发计划项目(2021AB12033);广西卫生健康委员会自筹经费科研课题(Z20200421,Z20210401) |
| Author Name | Affiliation | E-mail | | He Xiantao | Department of Oncology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, China | | | Long Yusong | Department of Oncology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, China | | | Tan Junwen | Department of Oncology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, China | | | Li Gang | Department of Oncology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, China | | | Feng Yongfu | Department of Oncology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, China | | | Yang Hui | Department of Oncology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, China | | | Lu Ying | Department of Oncology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, China | | | Wang Zhanyu | Department of Oncology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, China | wzyliuhou@163.com |
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| Abstract:: |
| Objective To study the differences in the dosimetry and delivery time between helical tomotherapy (HT) and volumetric modulated arc therapy (VMAT) in postoperative radiotherapy of synchronous bilateral breast cancer (SBBC) and to explore the feasibility of clinical application of the HT technology.Methods A retrospective analysis was conducted for nine SBBC patients who underwent modified radical postoperative radiotherapy in the Fourth Affiliated Hospital of Guangxi Medical University from February 2017 to May 2022. For each patient, the Precision planning system was used to formulate the HT plan, and the RayStation planning system was employed to develop the VMAT plan. All plans obtained were divided into HT group and VMAT group according to plan type. The paired sample t-test was used to compare the dosimetric parameters of the target volume and organ at risk (OAR) and delivery time between the two radiotherapy technologies.Results The plans of both groups could meet the clinical treatment requirements. The coverage (D95% and V100%), conformity index (CI), average dose (Dmean), and median dose (D50%) of the target volumes in the HT group were better than those in the VMAT group, and the differences were statistically significant (t=-3.21, -3.39, -5.03, 3.76, 4.97, P < 0.05). The differences in the maximum dose (D2%), minimum dose (D98%), high dose volumes (V107% and V110%), and homogeneity index (HI) of the target volumes between the two groups were not statistically significant (P > 0.05). Regarding the OAR, the V20 and Dmean of both lungs in the HT group were significantly lower than those in the VMAT group, but the irradiation volume V5 of both lungs in the HT group was significantly higher than that in the VMAT group (t=-3.01, 3.83, -2.81, P < 0.05). Moreover, V20, V30, V40, and Dmean of heart and the V20 and Dmean of liver in the HT group were significantly lower than those in the VMAT group, with statistically significant differences (t=3.76, -2.83, -2.74, 5.93, 4.57, 4.48, P < 0.05). There was no significant difference in the radiation doses to other OARs (spinal cord, thyroid gland, and humerus head, P > 0.05). The delivery time of the HT group was significantly higher than that of the VMAT group (t = 11.32, P < 0.05).Conclusions Compared with VMAT, HT has greater dosimetric advantages, and can provide higher target coverage, conformability and average dose, and significantly reduce the overall radiation doses to both lungs, heart, and liver in OARs. However, the irradiation volume V5 at low-dose areas of both lungs and the delivery time in the HT group are higher than those in the VMAT group, but still meet the clinical treatment requirements. Therefore, it is feasible to apply the HT technology to the modified radical postoperative radiotherapy of SBBC. |
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