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
Nissen, H. D.
Yates, E. S.
Boersma, L. J.
Lorenzen, E. L.
Nielsen, M. E. K.
Offersen, B. V.
AffiliationOncology Institute, Radiation Therapy Unit, Rambam Medical Center, Haifa, Israel; Breast Radiation Unit, Sheba Tel Ha'shomer, Ramat Gan, Israel; School for Oncology and Developmental Biology (GROW), Maastricht University Medical Centre, Maastricht, the Netherlands.
MetadataShow full item record
AbstractAims: 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.
CitationKaidar-Person O, Nissen HD, Yates ES, Andersen K, Boersma LJ, Boye K, et al. 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. Clin Oncol (R Coll Radiol). 2020.
- Target coverage and cardiopulmonary sparing with the updated ESTRO-ACROP contouring guidelines for postmastectomy radiation therapy after breast reconstruction: a treatment planning study using VMAT and proton PBS techniques.
- Authors: Milligan MG, Zieminski S, Johnson A, Depauw N, Rosado N, Specht MC, Liao EC, Jimenez RB
- Issue date: 2021 Nov
- Left-sided breast cancer loco-regional radiotherapy with deep inspiration breath-hold: Does volumetric-modulated arc radiotherapy reduce heart dose further compared with tangential intensity-modulated radiotherapy?
- Authors: Pham TT, Ward R, Latty D, Owen C, Gebski V, Chojnowski J, Kelly C, Ahern V, Tiver K, Stuart K, Wang W
- Issue date: 2016 Aug
- A Retrospective Dosimetric Analysis of the New ESTRO-ACROP Target Volume Delineation Guidelines for Postmastectomy Volumetric Modulated Arc Therapy After Implant-Based Immediate Breast Reconstruction.
- Authors: Chang KH, Chang JS, Park K, Chung SY, Kim SY, Park RH, Han MC, Kim J, Kim H, Lee H, Kim DW, Kim YB, Kim JS, Hong CS
- Issue date: 2020
- Dosimetric comparison of hybrid volumetric-modulated arc therapy, volumetric-modulated arc therapy, and intensity-modulated radiation therapy for left-sided early breast cancer.
- Authors: Lin JF, Yeh DC, Yeh HL, Chang CF, Lin JC
- Issue date: 2015 Autumn
- A VMAT planning technique for locally advanced breast cancer patients with expander or implant reconstructions requiring comprehensive postmastectomy radiation therapy.
- Authors: Kuo L, Ballangrud ÅM, Ho AY, Mechalakos JG, Li G, Hong L
- Issue date: 2019 Summer