ArticleJournal of medical physics
Dosimetric Comparison of Sequential Boost versus Simultaneous Integrated Boost Intensity-modulated Delivery Techniques in Left-sided Breast Cancer Radiotherapy: A Planning Study.
Article in Journal of medical physics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: This research compares the dosimetric characteristics of sequential boost (SB) and simultaneous integrated boost (SIB) techniques using intensity-modulated delivery techniques for breast radiotherapy in left-sided breast cancer patients following breast-conserving surgery (BCS). Materials and Methods: Twenty-seven left-sided breast cancer patients who underwent BCS were retrospectively analyzed. Two treatment plans per patient were generated using Eclipse Treatment Planning System. SB delivered 40 Gy/15 fractions (four-arc volumetric modulated arc therapy [VMAT]) to whole breast, then 12.5 Gy/5 fractions (six-field intensity-modulated radiotherapy [IMRT]) to tumor bed, totaling 52.5 Gy/20 fractions. SIB delivered 40 Gy to whole breast and 48 Gy to tumor bed simultaneously in 15 fractions through four-arc VMAT. Target coverage, dose homogeneity, conformity, and organ-at-risk doses were compared using paired Results: Both techniques achieved adequate target coverage with comparable whole breast mean doses. SB demonstrated significantly superior V95% coverage (98.4% vs. 95.7%), while SIB significantly achieved superior dose homogeneity within the integrated plan (HI: 0.31 ± 0.025 vs. 0.14 ± 0.032). SIB showed 31% reduction in total monitor units (10669 ± 881 vs. 15450 ± 1374 MU, Conclusion: Both techniques achieved adequate target coverage, SIB offers superior treatment efficiency and coronary artery sparing, while SB provides better V95% coverage and lung sparing. Technique selection should be individualized based on patient factors and institutional priorities.
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