ArticleJournal of medical radiation sciences2022
Comprehensive nodal breast VMAT: solving the low-dose wash dilemma using an iterative knowledge-based radiotherapy planning solution.
Article in Journal of medical radiation sciences, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed, 19 citations in OpenAlex.
- Reducing low-dose exposure in helical TomoTherapy for locally advanced left-sided breast cancer with a deformable image registration-based dose-mimicking workflow.Journal of applied clinical medical physics · 2026Article
- Development and Evaluation of Knowledge-Based Treatment Plans for Chest Wall and Regional Lymph Node Irradiation.Cureus · 2026Article
- Risk factors for early-onset radiodermatitis in patients with locally advanced breast cancer: a comparative analysis of volumetric modulated arc therapy and intensity-modulated radiotherapy.Breast cancer (Tokyo, Japan) · 2025Article
- Automated rapidplan model validation using Eclipse scripting API.Journal of applied clinical medical physics · 2025Article
- Why is Volumetric Modulated Arc Therapy Not Considered the Standard of Care for Locoregional Radiation Therapy for Breast Cancer Patients?Advances in radiation oncology · 2025Article
- Minimizing normal tissue low dose bath for left breast Volumetric Modulated Arc Therapy (VMAT) using jaw offset.Journal of applied clinical medical physics · 2024Article
- Dosimetric analysis of half-field-based VMAT with the deep inspiration breath-hold technique for left breast cancer patients following breast-conserving surgery.Frontiers in oncology · 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
- A method for beam's eye view breath-hold monitoring during breast volumetric modulated arc therapy.Physics and imaging in radiation oncology · 2023Article
- Knowledge-based DVH estimation and optimization for breast VMAT plans with and without avoidance sectors.Radiation oncology (London, England) · 2022Article
- Evaluating the utility of knowledge-based planning for clinical trials using the TROG 08.03 post prostatectomy radiation therapy planning data.Physics and imaging in radiation oncology · 2022Article
- Comprehensive nodal breast VMAT: solving the low-dose wash dilemma using an iterative knowledge-based radiotherapy planning solution.Journal of medical radiation sciences · 2022Article
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Authors and funding
16 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAimed to develop a simple and robust volumetric modulated arc radiotherapy (VMAT) solution for comprehensive lymph node (CLN) breast cancer without increase in low-dose wash.
methodsForty CLN-breast patient data sets were utilised to develop a knowledge-based planning (KBP) VMAT model, which limits low-dose wash using iterative learning and base-tangential methods as benchmark. Another twenty data sets were employed to validate the model comparing KBP-generated ipsilateral VMAT (ipsi-VMAT) plans against the benchmarked hybrid (h)-VMAT (departmental standard) and bowtie-VMAT (published best practice) methods. Planning target volume (PTV), conformity/homogeneity index (CI/HI), organ-at-risk (OAR), remaining-volume-at-risk (RVR) and blinded radiation oncologist (RO) plan preference were evaluated.
resultsIpsi- and bowtie-VMAT plans were dosimetrically equivalent, achieving greater nodal target coverage (P < 0.05) compared to h-VMAT with minor reduction in breast coverage. CI was enhanced for a small reduction in breast HI with improved dose sparing to ipsilateral-lung and humeral head (P < 0.05) at immaterial expense to spinal cord. Significantly, low-dose wash to OARs and RVR were comparable between all plan types demonstrating a simple VMAT class solution robust to patient-specific anatomic variation can be applied to CLN breast without need for complex beam modification (hybrid plans, avoidance sectors or other). This result was supported by blinded RO review.
conclusionsA simple and robust ipsilateral VMAT class solution for CLN breast generated using iterative KBP modelling can achieve clinically acceptable target coverage and OAR sparing without unwanted increase in low-dose wash associated with increased second malignancy risk.
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