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Title: $Comparative study on three kind techniques in whole breast radiation therapy
Abstract: Objective To compare the dosimetric features of three kind whole breast radiation therapeutic techniques. Methods Ten patients of breast cancer received breast conserved surgery and whole breast irradiation were enrolled, all females, aged 25 - 58 years, median age 42 years. Three kinds of radiation plan were designed as conventional wedged tangential technique, field- in-field intensity modulated radiation therapy(IMRT) and multibeam IMRT. The dosimetric characters were compared among 3 plans. Results Compared with the conventional wedged tangential technique, the field-in- field IMRT plan had better dose distribution in the whole breast. The dose covering 99 % planning target volume(PTV)(D99) increased from (4 640 ± 72) cGy to (4 753 ± 25) cGy (P 0.05); The heterogeneity index decreased from 1.104 to 1.060 (P 0.05). There were no significant difference of dose irradiated to organs at risks in the conventional wedged tangential technique and field-in-field IMRT plan. There were no significant difference of dose distribution in PTV between the field-in-field IMRT plan and multibeam IMRT plan. Compared with the field-in-field IMRT plan, the multibeam IMRT plan increased the volume of normal tissues receiving low- dose. The volume of heart receiving dose more than 10 Gy(V10) increased from (13.0 ± 8.5) % to (53.3 ± 22.7) %(P 0.05); The volume of ipsilateral lung receiving dose ,V10 , increased from (25.2 ± 3.4) % to (42.7 ± 3.7) %(P 0.05); The V5 (the volume of receiving dose in contralateral breast,contralateral lung and mean healthy tissue ) increased from (1.9 ± 3.1) % to (32.6 ± 2.3) %, 0 to (18.5 ± 8.3) % and (9.9 ± 1.0) % to (32.1 ± 3.6) %(P 0.05,for all). Conclusion It is demonstrated that the field-in-field IMRT plan provides better dose distribution than conventional plan, and the multibeam IMRT plan increases the volume of normal tissues receiving low-dose without further improving dose distribution base on field-in-field IMRT.