ArticleFrontiers in medicine2026
Radiobiological evaluation of hypofractionated vs. conventional VMAT for synchronous bilateral breast cancer: a focus on regional nodal irradiation.
Article in Frontiers in medicine, 2026. 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: To compare the radiobiological characteristics of hypofractionated radiotherapy (HFRT) and conventional fractionated radiotherapy (CFRT) delivered with volumetric modulated arc therapy (VMAT) for synchronous bilateral breast cancer (SBBC) requiring regional nodal irradiation (RNI). Methods: Eighteen patients with SBBC receiving bilateral breast/chest wall irradiation and comprehensive nodal coverage were retrospectively included. For each patient, VMAT plans were generated for CFRT (50 Gy in 25 fractions) and HFRT (40.05 Gy in 15 fractions). Dosimetric parameters of the planning target volume (PTV) were evaluated. Radiobiological assessment included equivalent uniform dose (EUD), tumor control probability (TCP), and normal tissue complication probability (NTCP). TCP was calculated using LQ-Poisson and Niemierko models, while NTCP for the lungs, heart, spinal cord, and esophagus was estimated using Lyman Kutcher Burman and Niemierko models. Results: Both regimens achieved excellent target coverage, with mean PTV V Conclusion: For SBBC patients requiring RNI, HFRT-VMAT achieved target coverage comparable to CFRT while reducing excessive high-dose regions and predicted toxicity to major thoracic organs. Despite slightly lower TCP values, overall tumor control remained favorable, supporting HFRT-VMAT as a feasible treatment option for this patient population.
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