Work

Comparison of different radiotherapy planning techniques in breast cancer using active breathing coordinator

Year: 2026

Type: article

Abstract: Background: To identify the optimal radiotherapy planning technique that provides the best dosimetric outcomes in terms of target coverage and sparing of organs at risk (OAR) when using deep inspiration breath-holding (DIBH) for early left-sided breast cancer treatment. Materials and methods: Thirty patients with early-stage left-sided BC had been simulated and treated before with DIBH using the active breathing coordinator (ABC) system. Each patient underwent replanning using 3D conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), and volumetric-modulated arc therapy (VMAT) techniques with a prescription dose of 40.05 Gy over 15 fractions. The planning target volume (PTV) and OARs were evaluated utilizing dose-volume histograms (DVH). Dosimetric parameters [V 95 , D 98 , D 50 , D 2 , V 107 , conformity index (CI), homogeneity index (HI)], and OAR metrics for the heart, left anterior descending artery (LAD), lungs, and contralateral breast were analyzed statistically. Results: VMAT achieved the best PTV coverage and homogeneity (HI = 0.1). The mean heart dosage was lowest for 3DCRT (1.9 Gy) and VMAT (2 Gy), whereas for the LAD VMAT achieved the lowest dosages (D mean = 5.2 Gy; D max = 17.3 Gy; p < 0.001). For the ipsilateral lung, 3DCRT offered superior low-dose sparing, while VMAT minimized high-dose exposure. Contralateral lung and breast doses were lowest with 3DCRT. Conclusions: VMAT offers superior target conformity and cardiac sparing specifically for the LAD, whereas 3DCRT minimizes contralateral organs and low-dose lung exposure. These findings highlight the necessity for personalized treatment, whether the priority is to limit cardiac toxicity or decrease low-dose exposure to the patient.

Source: Reports of Practical Oncology & Radiotherapy

DOI: 10.5603/rpor.113430

Authors: Yara G. Farid, Mohamed S. Ibrahim, Medhat W. Shafaa, Noha A. Rahmoun, Magdy M. Khalil, Khalid A. Khalil

Institutions: Helwan University, Cairo University, Cairo University hospitals, Badr University in Cairo

Language: English

Topic: Advanced Radiotherapy Techniques

Subfield: Radiation

Field: Physics and Astronomy

Domain: Physical Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,713