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Open Access 01-04-2021 | Breast Cancer | Original Article

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

Authors: Alexander Venjakob, Michael Oertel, Dominik Alexander Hering, Christos Moustakis, Uwe Haverkamp, Hans Theodor Eich

Published in: Strahlentherapie und Onkologie | Issue 4/2021

Abstract

Purpose

This study aims to evaluate the best possible practice using hybrid volumetric modulated arc therapy (H-VMAT) for hypofractionated radiation therapy of breast cancer. Different combinations of H‑VMAT—a combination of three-dimensional radiotherapy (3D-CRT) and VMAT—were analyzed regarding planning target volume (PTV), dose coverage, and exposure to organs at risk (OAR).

Methods

Planning computed tomography scans were acquired in deep-inspiration breath-hold. A total of 520 treatment plans were calculated and evaluated for 40 patients, comprising six different H‑VMAT plans and a 3D-CRT plan as reference. H‑VMAT plans consisted of two treatment plans including 3D-CRT and VMAT. During H‑VMAT planning, the use of hard wedge filters (HWF) and beam energies were varied. The reference plans were planned with mixed beam energies and the inclusion/omission of HWF.

Results

Compared to the reference treatment plans, all H‑VMAT plans showed consistently better PTV dose coverage, conformity, and homogeneity. Additionally, OAR protection was significantly improved with several H‑VMAT combinations (p < 0.05). The comparison of different H‑VMAT combinations showed that inclusion of HWF in the base plan had a negative impact on PTV dose coverage, conformity, and OAR exposure. It also increased the planned monitor units and beam-on time. Advantages of using lower beam energies (6-MV photons) in both the base plan and in the VMAT supplementary dose were observed.

Conclusion

The H‑VMAT technique is an effective possibility for generating homogenous and conformal dose distributions. With the right choice of H‑VMAT combination, superior OAR protection is achieved compared to 3D-CRT.

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Title: Hybrid volumetric modulated arc therapy for hypofractionated radiotherapy of breast cancer: a treatment planning study
Authors: Alexander Venjakob
Michael Oertel
Dominik Alexander Hering
Christos Moustakis
Uwe Haverkamp
Hans Theodor Eich
Publication date: 01-04-2021
Publisher: Springer Berlin Heidelberg
Keywords: Breast Cancer
Breast Cancer
Radiotherapy
Published in: Strahlentherapie und Onkologie / Issue 4/2021
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-020-01696-8

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

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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