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Accelerated hypofractionated radiotherapy for chest wall and nodal irradiation using hybrid techniques

Published online by Cambridge University Press:  13 December 2021

Karunakaran Balaji Open the ORCID record for Karunakaran Balaji [Opens in a new window]  and
Velayudham Ramasubramanian Open the ORCID record for Velayudham Ramasubramanian [Opens in a new window]
Karunakaran Balaji
Affiliation:
School of Advanced Sciences, Vellore Institute of Technology, Vellore, India Department of Radiation Oncology, Gleneagles Global Hospitals, Chennai, India
Velayudham Ramasubramanian*
Affiliation:
School of Advanced Sciences, Vellore Institute of Technology, Vellore, India
*
Author for correspondence: Dr. Velayudham Ramasubramanian, Professor, School of Advanced Sciences, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India. Tel: +919994728148. E-mail: vrsramasubramanian@gmail.com
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Abstract

Aim:

This study compares three different hybrid plans, for left-sided chest wall (CW) and nodal stations irradiation using a hypofractionated dose regimen.

Materials and methods:

Planning target volumes (PTVs) of 25 breast cancer patients that included CW, supraclavicular (SCL) and internal mammary node (IMN) were planned with 3 different hybrid techniques: 3DCRT+IMRT, 3DCRT+VMAT and IMRT+VMAT. All hybrid plans were generated with a hypofractionated dose prescription of 40·5 Gy in 15 fractions. Seventy per cent of the dose was planned with the base-dose component and remaining 30% of the dose was planned with the hybrid component. All plans were evaluated based on the PTVs and organs at risk (OARs) dosimetric parameters.

Results:

The results for PTVs parameters have shown that the 3DCRT+IMRT and 3DCRT+VMAT plans were superior in uniformity index to the IMRT+VMAT plan. The OARs dose parameters were comparable between hybrid plans. The IMRT+VMAT plan provided a larger low dose volume spread to the heart and ipsilateral lung (p < 0·001). The 3DCRT+VMAT plan required less monitor units and treatment time (p = 0·005) than other plans.

Conclusion:

The 3DCRT+VMAT hybrid plan showed superior results with efficient treatment delivery and provide clinical benefit by reducing both low and high dose levels.

Keywords

breast cancerchest wallhybrid planshypofractionationIMRTVMAT
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 22 , 2023 , e21
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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