Simultaneous-integrated boost intensity-modulated radiation therapy (SIB-IMRT) in the treatment of early-stage left-sided breast carcinoma

Rajanish Singla, Stephanie King, Kevin Albuquerque, Steve Creech, Nesrin Dogan

Research output: Contribution to journalArticle

53 Scopus citations

Abstract

We assessed the feasibility and impact of simultaneous-integrated boost intensity-modulated radiation therapy (SIB-IMRT) in the treatment of left breast carcinoma and compared target coverage and normal tissue doses with SIB-IMRT and 3-dimensional (3D) conformal RT using opposed tangential fields. For each of 10 patients with early-stage left-sided invasive breast carcinoma, 5 plans were generated; the first 4 were 3D conformal opposed tangential fields-2 with wedges, 2 with compensators and either photon or electron boost. A dose of 50.4 Gy in 28 fractions was prescribed to the left breast and an additional 16 Gy in 8 fractions to the lumpectomy bed. When compared to the tangential plans, SIB-IMRT maintained coverage (V95%) to the left breast and lumpectomy bed without significantly increasing the left breast maximum dose. SIB-IMRT was able to reduce the lung mean dose, maximum dose, and the V20 by 55-104 cGy, 983-1298 cGy (p < 0.001), and 3.7-4.4%, respectively. In addition, SIB-IMRT reduced the maximum heart dose by 1032-1173 cGy and contralateral breast dose was increased (although p = NS). The mean and maximum dose to the unspecified tissues was also significantly reduced by 81-88 cGy and 516-942 cGy, respectively. SIB-IMRT resulted in a significant improvement in target dose conformality by up to 67%. Our findings that SIB-IMRT could improve dose conformality, reduce total treatment times, and reduce some of the normal structure doses presents it as an alternative technique for adjuvant breast radiotherapy; however this needs to be studied further in the clinic setting.

Original languageEnglish (US)
Pages (from-to)190-196
Number of pages7
JournalMedical Dosimetry
Volume31
Issue number3
DOIs
Publication statusPublished - Sep 2006

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Keywords

  • Breast cancer
  • IMRT
  • Simultaneous-integrated boost

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Health Professions(all)
  • Radiation

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