DOSIMETRIC ANALYSIS OF DEEP INSPIRATION BREATH HOLD TECHNIQUE ADAPTED TO TANGENTIAL-BASED VOLUMETRIC MODULATED ARC THERAPY FOR LEFT BREAST CANCER AFTER MASTECTOMY

Authors : Dicle Aslan, Mustafa Tarkan Aksozen

Pages : 402-410

Doi:10.16919/bozoktip.1697281

View : 39 | Download : 99

Publication Date : 2025-12-15

Article Type : Research Paper

Abstract :Purpose: To evaluate the dosimetric properties of the deep inspiration breath hold (DIBH) technique adapted to tangential-based volumetric modulated arc therapy (TVMAT) in left breast cancer patients with mastectomy. Method: Forty-three patients who underwent mastectomy and received chest wall and regional lymph node irradiation were included in the study. Simulation computed tomography (CT) was performed in DIBH and free-breathing (FB). Two plans were created for each patient; DIBH-TVMAT and FB-TVMAT. Both plans were realized using a mono-isocentric technique with two partial arc rotations, and the same gantry angles were used.The standard fractionation schedule for each patient was set to 50 Gy in 25 fractions. Paired-sample T-test was used to evaluate the dosimetric parameters. Results: The comparison between FB-TVMAT and DIBH-TVMAT plans revealed mean heart doses of 8.9 Gy and 5.4 Gy, respectively (p=0.000). A 6.2% reduction was encountered in left lung volume receiving 5 Gy (V5) in the DIBH-TVMAT plan (p=0.01). A reduction of 1.3 Gy at a percentage of 28% was monitored in the mean dose of the right lung in DIBH-TVMAT (p=0.000). The mean right breast dose was 0.7 Gy lower in DIBH-TVMAT (p=0.000). Conclusion: The results support that the adaptation of DIBH to TVMAT allows an optimal target volume dose coverage as well as leads to significant dose reductions in the left lung, right lung, heart, LADCA, and right breast for the left breast cancer patients with mastectomy.
Keywords : Derin inspiryumda nefes tutma, Tanjansiyel hacimsel modüleli ark terapisi, Meme kanseri, Radyoterapi, Mastektomi

ORIGINAL ARTICLE URL