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Open Access 01-12-2011 | Research

Mixed modality treatment planning of accelerated partial breast irradiation: to improve complex dosimetry cases

Authors: Mohamed El Nemr, Steve Heymann, Rodolfe Verstraet, Bruno Biron, Fares Azoury, Hugo Marsiglia, Céline Bourgier

Published in: Radiation Oncology | Issue 1/2011

Background

Although 3D-conformal accelerated partial breast irradiation (APBI) is widely used, several questions still remain such as what are the optimal treatment planning modalities. Indeed, some patients may have an unfavorable anatomy and/or inadequate dosimetric constraints could be fulfilled ("complex cases"). In such cases, we wondered which treatment planning modality could be applied to achieve 3D-conformal APBI (2 mini-tangents and an "en face" electron field or non-coplanar photon multiple fields; or a mixed technique combining non-coplanar photon multiple fields with an "en face" electron beam).

Methods

From October 2007 to March 2010, 55 patients with pT1N0 breast cancer were enrolled in a phase II APBI trial. Among them, 7 patients were excluded as they were considered as "complex cases". A dosimetric comparison was performed according to the 3 APBI modalities mentioned above and assessed: planning treatment volume (PTV) coverage, PTV/whole breast ratio, lung and heart distance within irradiated field and exposure of organs at risk (OAR).

Results

Adequate PTV coverage was obtained with the 3 different treatment planning. Regarding OAR exposure, the "mixed technique" seemed to reduce the volume of non-target breast tissue in 4 cases compared to the other techniques (in only 1 case), with the mean V_50% at 44.9% (range, 13.4 - 56.9%) for the mixed modality compared to 51.1% (range, 22.4 - 63.4%) and 51.8% (range, 23.1 - 59.5%) for the reference and non-coplanar techniques, respectively. The same trend was observed for heart exposure.

Conclusions

The mixed technique showed a promising trend of reducing the volume of non-target breast tissue and heart exposure doses in APBI "complex cases".

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Title: Mixed modality treatment planning of accelerated partial breast irradiation: to improve complex dosimetry cases
Authors: Mohamed El Nemr
Steve Heymann
Rodolfe Verstraet
Bruno Biron
Fares Azoury
Hugo Marsiglia
Céline Bourgier
Publication date: 01-12-2011
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2011
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/1748-717X-6-154

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Mixed modality treatment planning of accelerated partial breast irradiation: to improve complex dosimetry cases

Background

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Background

Background

Methods

Results

Conclusions

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