Hybrid volumetric modulated arc therapy for hypofractionated radiotherapy of breast cancer: a treatment planning study

• DOI: 10.1007/s00066-020-01696-8
• Publication Date: 2020-10-17T09:02:58Z
• Authors: Alexander Venjakob; Michael Oertel; Dominik Alexander...; Christos Moustakis; Uwe Haverkamp; Hans Theodor Eich
• Keywords: Organs at Risk; Breast Neoplasms; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Humans; Original Article; Female; Radiation Dose Hypofractionation; Algorithms [MeSH] ; Female [MeSH] ; Clinical application ; Breast radiation therapy ; Humans [MeSH] ; Hybrid planning ; Radiotherapy, Intensity-Modulated/adverse effects [MeSH] ; Breast Neoplasms/radiotherapy [MeSH] ; Hypofractionation ; Original Article ; Treatment planning challenge ; Radiation Dose Hypofractionation [MeSH] ; Organs at Risk [MeSH] ; Breast/radiation effects [MeSH] ; Radiotherapy, Intensity-Modulated/methods [MeSH]; Breast; Radiotherapy, Intensity-Modulated; Algorithms

Abstract Purpose This study aims to evaluate the best possible practice using hybrid volumetric modulated arc therapy (H-VMAT) for hypofractionated radiation of breast cancer. Different combinations H‑VMAT—a combination three-dimensional radiotherapy (3D-CRT) and VMAT—were analyzed regarding planning target volume (PTV), dose coverage, exposure organs at risk (OAR). Methods Planning computed tomography scans were acquired in deep-inspiration breath-hold. A total 520 treatment plans calculated evaluated 40 patients, comprising six different H‑VMAT a 3D-CRT plan as reference. consisted two including VMAT. During planning, use hard wedge filters (HWF) beam energies varied. The reference planned with mixed inclusion/omission HWF. Results Compared plans, all showed consistently better PTV conformity, homogeneity. Additionally, OAR protection was significantly improved several ( p < 0.05). comparison that inclusion HWF base had negative impact on exposure. It also increased monitor units beam-on time. Advantages lower (6-MV photons) both VMAT supplementary observed. Conclusion technique is an effective possibility generating homogenous conformal distributions. With right choice combination, superior achieved compared 3D-CRT.