ArticleRadiation oncology (London, England)2022
Dosimetric effect of respiratory motion on planned dose in whole-breast volumetric modulated arc therapy using moderate and ultra-hypofractionation.
Article in Radiation oncology (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 8 citations in OpenAlex.
- Article
- Comparative dosimetric evaluation of independent verification systems: ArcherQA versus AccuCheck for volumetric modulated Arc therapy plan validation.Radiation oncology (London, England) · 2026Article
- Assessing respiratory motion effects after breathing training on hybrid and IMRT plans in hypofractionated breast radiotherapy.Radiation oncology (London, England) · 2026Article
- Robustness of hypofractionated breast radiotherapy after breast-conserving surgery with free breathing.Frontiers in oncology · 2023Article
- Impact of Respiratory Motion on the Skin Dose for Breast Cancer in Tomotherapy: A Study in the In-house Moving Phantom.Technology in cancer research & treatmentArticle
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Authors and funding
5 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
background and purposeThe interplay effect of respiratory motion on the planned dose in free-breathing right-sided whole-breast irradiation (WBI) were studied by simulating hypofractionated VMAT treatment courses. MATERIALS AND
methodsTen patients with phase-triggered 4D-CT images were included in the study. VMAT plans targeting the right breast were created retrospectively with moderately hypofractionated (40.05 Gy in 15 fractions of 2.67 Gy) and ultra-hypofractionated (26 Gy 5 fractions of 5.2 Gy) schemes. 3D-CRT plans were generated as a reference. All plans were divided into respiratory phase-specific plans and calculated in the corresponding phase images. Fraction-specific dose was formed by deforming and summing the phase-specific doses in the planning image for each fraction. The fraction-specific dose distributions were deformed and superimposed onto the planning image, forming the course-specific respiratory motion perturbed dose distribution. Planned and respiratory motion perturbed doses were compared and changes due to respiratory motion and choice of fractionation were evaluated.
resultsThe respiratory motion perturbed PTV coverage (V95%) decreased by 1.7% and the homogeneity index increased by 0.02 for VMAT techniques, compared to the planned values. Highest decrease in CTV coverage was 0.7%. The largest dose differences were located in the areas of steep dose gradients parallel to respiratory motion. The largest difference in DVH parameters between fractionation schemes was 0.4% of the prescribed dose. Clinically relevant changes to the doses of organs at risk were not observed. One patient was excluded from the analysis due to large respiratory amplitude.
conclusionRespiratory motion of less than 5 mm in magnitude did not result in clinically significant changes in the planned free-breathing WBI dose. The 5 mm margins were sufficient to account for the respiratory motion in terms of CTV dose homogeneity and coverage for VMAT techniques. Steep dose gradients near the PTV edges might decrease the CTV coverage. No clinical significance was found due to the choice of fractionation.
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