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Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Postmastectomy Radiation Therapy Planning After Immediate Implant-based Reconstruction Using the European Society for Radiotherapy and Oncology-Advisory Committee in Radiation Oncology Practice Consensus Guidelines for Target Volume Delineation

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  • O. Kaidar-Person
  • H. D. Nissen
  • E. S. Yates
  • K. Andersen
  • L. J. Boersma
  • K. Boye
  • R. Canter
  • E. Costa
  • S. Daniel
  • S. Hol
  • I. Jensen
  • E. L. Lorenzen
  • I. Mjaaland
  • M. E.K. Nielsen
  • P. Poortmans
  • J. Vikström
  • J. Webb
  • B. V. Offersen
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Aims: To evaluate how common radiation therapy techniques perform in the setting of the new European Society for Radiotherapy and Oncology-Advisory Committee in Radiation Oncology Practice (ESTRO-ACROP) delineation recommendations for immediate breast reconstruction (IBR). Materials and methods: Seven Danish radiation therapy centres and six international European centres participated in this project. Two breast cancer cases (one left-sided and one right-sided) with a retropectoral implant were chosen for radiation therapy planning using deep-inspiration breath-hold. Target volumes were delineated according to ESTRO-ACROP delineation recommendations. The centres were asked to plan the cases using any radiation therapy technique according to the Danish Breast Cancer Group plan objectives. Results: In total, 35 treatment plans were collected. Half of the submitted plans, for both the left-sided and the right-sided case, used the field-in-field (FiF) technique (nine for each), a quarter used volumetric arc radiation therapy (VMAT; five for right-sided, four for left-sided) and the remaining quarter was a mix of inverse intensity-modulated radiation therapy (IMRT), helicoidal therapy and hybrid (combined open fields and VMAT) techniques. Mean clinical target volume doses were in the range 99–102% of the prescribed dose. The median FiF mean heart dose (MHD) for right-sided radiation therapy was 1 Gy (range 0.8–3.7) and 5.2 Gy for left-sided radiation therapy (range 2.2–6.5). For right-sided radiation therapy, the median VMAT MHD was 3.42 Gy, for IMRT was 2.3 Gy and for helicoidal therapy was 5.1 Gy. For left-sided radiation therapy, the median VMAT MHD was 6.3 Gy, for IMRT was 7.8 Gy and for helicoidal therapy was 7.3 Gy. Conclusions: Different radiation therapy techniques could be used to plan radiation therapy in the setting of IBR. FiF provided good coverage with acceptable organ at risk doses. The best dose distribution results as a trade-off between the objectives of target volume coverage and high-dose organ at risk inclusion. The radiation therapy technique affects the interplay between these objectives.

OriginalsprogEngelsk
TidsskriftClinical Oncology
Vol/bind33
Udgave nummer1
Sider (fra-til)20-29
Antal sider10
ISSN0936-6555
DOI
StatusUdgivet - jan. 2021

Bibliografisk note

Funding Information:
We would like to thank all authors of the ESTRO-ACROP delineation guidelines for PMRT, who were not included in this paper for their work. B.V. Offersen is funded by the Danish Cancer Society and the Danish Comprehensive Cancer Center Radiotherapy group .

Publisher Copyright:
© 2020 The Royal College of Radiologists

ID: 75619818