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Development and comparison of a vmat classsolution versus 3d conformal radiotherapy fortangential breast cancer treatments

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  1. Tez No: 726992
  2. Yazar: GÖNLÜM ERDAŞ
  3. Danışmanlar: Belirtilmemiş.
  4. Tez Türü: Yüksek Lisans
  5. Konular: Radyasyon Onkolojisi, Radyoloji ve Nükleer Tıp, Radiation Oncology, Radiology and Nuclear Medicine
  6. Anahtar Kelimeler: VMAT, 3D CRT, breast cancer
  7. Yıl: 2015
  8. Dil: İngilizce
  9. Üniversite: Swansea Unıversıty
  10. Enstitü: Prıfysgol Abertawe
  11. Ana Bilim Dalı: Yurtdışı Enstitü
  12. Bilim Dalı: Belirtilmemiş.
  13. Sayfa Sayısı: Belirtilmemiş.

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Özet (Çeviri)

Background: Radiation therapy has an important role on the treatment of breast cancer. With improvements in medical physics and advancing technology several radiotherapy treatment techniques have been introduced. Volumetric modulated arc therapy (VMAT) is one of the newest techniques that is being clinically used today. Purpose: The aim of this study is to develop and compare a VMAT class solution versus 3D conformal radiotherapy (3D CRT) for tangential breast cancer treatments. Additionally the effects of changing the isocentre position, adding an additional dummy volume and modification of the target volume delineation are investigated as well. Methods: Eight left sided breast cancer patients who were previously treated with 3D CRT at Singleton Hospital (Swansea) under FAST-FORWARD trial protocol are selected for this study. The VMAT plans are created in the treatment planning system (TPS) Oncentra Masterplan® for Elekta Synergy® linac with 80-leaf multileaf collimator (MLC). Full double arc VMAT plans (WS) and two partial arc VMAT plans (CS) which is the class solution are optimized with patient specific DVO designation for all eight patients. Additionally, four extra plans are created for three of the patients by changing the isocentre position (ISO1 and ISO2), adding an additional dummy volume (POPTV) and modification of the target volume delineation (PTVM). Results: PTV V95% is generally comparable for CS (about 93%) to 3D CRT (about 94%) while WS (about 91%) shows worse PTV coverage. Average of HI and CI values for each plan for 8 patients are HI: 0.1267 (3D CRT), HI: 0.1474 (WS), and HI: 0.1162 (CS); CI: 0.9455 (3D CRT), CI: 0.9178 (WS), and CI: 0.9335 (CS). CS presents better OAR sparing compared to 3D CRT specifically for low dose levels (e.g. heart V5%) and for higher dose levels of the OARs, CS is comparable to 3D CRT. Doses to the OARs are increased for the WS plans. CS is comparable to 3D CRT for relatively high dose levels (e.g. 40% and 50%) while 3D CRT is superior to CS with regard to the body dose especially for low dose levels (e.g. <40%). Treatment time: 3:00 min (3D CRT), 5:40 min (WS) and 2:30 min (CS). Conclusion: The proposed partial arc VMAT class solution is considered to be a viable option for the left sided breast cancer patients. It allows reduction in dose to the OARs without compromising the target coverage and presents a comparable treatment time to 3D CRT.

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