Authors: Johansen, Safora¹; Vikströöm, Johan²; Hjelstuen, Mari Helene Blihovde²; Mjaaland, Ingvil²; Dybvik, Kjell Ivar²; Olsen, Dag Rune¹

Source: Acta Oncologica, Volume 50, Number 4, May 2011 , pp. 563-568(6)

Publisher: Informa Healthcare

Abstract:

<title>Abstract</title>

Purpose: To assess the impact of using breathing adapted radiotherapy on contralateral breast (CB) dose, to relate the thorax shape with the dose to the organs at risk (OARs) and to predict the risk for induced malignancies in CB using linear and non-linear models, following tangential irradiation of breast. Material and methods. Sixteen patients with stage I-II breast cancer treatment planned with tangential fields using deep inspiration breath hold (DIBH) and free breathing (FB) techniques were included in this analysis. The dose results mainly based on DVH analysis were compared. Four parameters were defined to describe thoracic shape. Excess relative risk (ERR) for cancer induction in CB, employing linear and non-linear models was calculated. Results. Average CB volumes exposed to a dose of 1 Gy is 1.3 times higher in DIBH plans than in FB plans. No significant difference in average V3Gy and V5Gy for DIBH and FB plans is observed. The average mean CB dose for DIBH and FB plans is 0.33 and 0.28 Gy, respectively. No correlation between thorax shape parameters and mean OARs dose is observed. The estimated average mean ERR with linear model is lower in FB plans (0.12) than for the DIBH plans (0.14). The estimated ERR with non-linear model is 0.14 for DIBH plans and 0.15 for FB plans. Conclusion. No significant difference in CB dose between DIBH and FB plans is observed. The four thorax shape parameters defined in this study can not be related to the dose at OARs using DIBH and FB radiation techniques. The ERR estimates for secondary CB cancer are nearly the same for FB and DIBH planning when using a linear and non-linear risk prediction models.

Document Type: Research article

DOI: http://dx.doi.org/10.3109/0284186X.2010.541933

Affiliations: 1: Institute for Cancer Research, Oslo University Hospital, Oslo, Norway 2: Department of Radiotherapy, Stavanger University Hospital, Stavanger, Norway

Publication date: 2011-05-01

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