ArticleJournal of applied clinical medical physics2019
Dosimetric comparison of VMAT with integrated skin flash to 3D field-in-field tangents for left breast irradiation.
Article in Journal of applied clinical medical physics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed.
- Objective-function-guided automated VMAT planning reduces OAR dose, low-dose exposure, and inter-planner variability in breast radiotherapy.Scientific reports · 2026Article
- Optimizing Breast Cancer Radiation therapy With Volumetric Modulated Arc Therapy and Skin Flash: A Case Study Using Deep Inspiration Breath Hold and Cherenkov Imaging.Advances in radiation oncology · 2025Article
- Dosimetric analysis of six whole-breast irradiation techniques in supine and prone positions.Scientific reports · 2024Article
- Evaluation of robustness of optimization methods in breast intensity-modulated radiation therapy using TomoTherapy.Physical and engineering sciences in medicine · 2024Article
- An IMRT planning technique for treating whole breast or chest wall with regional lymph nodes on Halcyon and Ethos.Journal of applied clinical medical physics · 2024Article
- Off-isocentric VMAT technique for breast cancer: Effective dose reduction to organs at risk and its applicability based on patient anatomy.Journal of applied clinical medical physics · 2024Article
- Comparative Study of Plan Robustness for Breast Radiotherapy: Volumetric Modulated Arc Therapy Plans with Robust Optimization versus Manual Flash Approach.Diagnostics (Basel, Switzerland) · 2023Article
- Dosimetric effect of respiratory motion on planned dose in whole-breast volumetric modulated arc therapy using moderate and ultra-hypofractionation.Radiation oncology (London, England) · 2022Article
- Article
- Predictors of heart and lung dose in left-sided breast cancer treated with VMAT relative to 3D-CRT: A retrospective study.PloS one · 2021Article
- In regards to Bogue J, Wan J, Lavey RS, Parsai EI. Dosimetric comparison of VMAT with integrated skin flash to 3D field-in-field tangents for left breast irradiation. Journal of applied clinical medical physics. 2019 Feb;20(2):24-9.Journal of applied clinical medical physics · 2019Article
- Planning System-dependent Recommendations of Intensity-modulated Technique for Breast Radiotherapy: A Literature Review-based Adaptation and Institutional Dosimetric Experience from a Large-volume Tertiary Cancer Care Hospital.Journal of medical physicsReview
- Comprehensive Comparison of Progressive Optimization Algorithm Based Automatic Plan and Manually Planned Treatment Technique for Cervical-Thoracic Esophageal Cancers.Technology in cancer research & treatmentArticle
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4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Volumetric modulated arc therapy (VMAT) has been implemented for left breast irradiation to reduce prescription dose to the heart and improve dose homogeneity across the targeted breast. Our in-house method requires application of a bolus during the optimization process with a target outside of the body, then removing the bolus during the final calculation in order to incorporate skin flash in VMAT plans. To quantify the dosimetric trade-offs between traditional 3D field-in-field tangents and VMAT with integrated skin flash for these patients, we compared nine consecutive patients who recently received radiation to their entire left breast but not their regional lymphatics. Tangent plans used non-divergent tangents of mixed energies and VMAT plans utilized four 6 MV arcs of roughly 260°. Mean dose to the heart, contralateral lung, and contralateral breast and their volume receiving 5%, 10%, and 20% of the prescription dose were higher in all nine VMAT plans than in the static tangential beam plans. For all critical structures, the mean VMAT DVH was higher in the low-dose region and crossed the 3D field-in-field DVH between 23.13% and 34.18% of the prescription dose (984.75-1454.70 cGy). However, the volume of the contralateral breast and heart receiving the prescription dose was slightly lower in the VMAT plans, but not statistically significant. VMAT provided superior homogeneity, with a mean homogeneity index of 9.41 ± 1.64 compared to 11.05 ± 1.82 for 3D tangents. Results indicate that VMAT spares the heart, contralateral lung, and contralateral breast from prescription dose at the cost of increasing their mean and low-dose volume and delivers a more homogenous dose distribution to the breast. For these reasons, VMAT is selectively applied at the request of the physician for left breast radiation without respiratory gating to spare the heart from prescription dose in cases of poor anatomical geometry.
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