Free breathing VMAT versus deep inspiration breath-hold 3D conformal radiation therapy for early stage left-sided breast cancer
Peer reviewed, Journal article
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Original versionJournal of Applied Clinical Medical Physics. 2021, 22 (4), 44-51. 10.1002/acm2.13208
The purpose of the in silico study was to compare free breathing volumetric modu-lated arc therapy (VMAT) to standard deep inspiration breathhold (DIBH) threedi-mensional conformal radiotherapy (3DCRT) and determine whether the former is aviable option for elderly patients with leftsided early stage breast cancer. Data from22 patients with earlystage left breast carcinoma requiring breastonly radiationtherapy were used for this planning study. The robustness of VMAT plans whenusing the free breathing method was compared to that of standard 3DCRT plansusing the DIBH method. The endpoints for evaluation were the target dose cover-age as well as doses to the organsatrisk. The free breathing VMAT plans produceda signicantly higher mean dose to the heart and right breast than the DIBH3DCRTplans. Free breathing VMAT plans resulted in signicantly better target coveragethan did 3DCRT using DIBH. The external volume that received more than 40 Gywas signicantly smaller in the VMAT plans. Free breathing VMAT is a viable alter-native to DIBH 3DCRT in elderly patients with a limited life expectancy and in sub-jects who are unable to perform DIBH. The choice of treatment should beindividualized, and all relevant risks ought to be considered.