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Detection of Optimal Tangential Partial Arc Span for VMAT Planning in IntactLeft-Breast Treatment


U Giri

U Giri*, B Sarkar , A Munshi , H Kaur , k jassal , S Rathinamuthu , S Kumar , T Ganesh , B Mohanti , Fortis Memorial Research Institute, Gurgaon, Haryana

Presentations

SU-F-T-422 (Sunday, July 31, 2016) 3:00 PM - 6:00 PM Room: Exhibit Hall


Purpose:This study was designed to investigate an appropriate arc span for intact partial Left breast irradiation by VMAT planning.

Methods:Four cases of carcinoma left intact breast was chosen randomly for this study. Both medial tangential and left-lateral tangential arc (G20°, G25°, G30°, G35°, G40°) were used having the same length and bilaterally symmetric. For each patient base plan was generated for 30° arc and rest of other arc plans were generated by keeping all plan parameters same, only arc span were changed. All patient plans were generated on treatment planning system Monaco (V 5.00.02) for 50 Gy dose in 25 fractions. PTV contours were clipped 3 mm from skin (patient). All plans were normalized in such a way that 95 % of prescription dose would cover 96 % of PTV volume.

Results:Mean MU for 20°, 25°, 30°, 35° and 40° were 509 ± 18.8, 529.1 ± 20.2, 544.4 ± 20.8, 579.1 ±51.8, 607.2 ± 40.2 similarly mean hot spot (volume covered by 105% of prescription dose) were 2.9 ± 1.2, 3.7 ± 3.0, 1.5 ± 1.7, 1.3±0.6, 0.4 ± 0.4, mean contralateral breast dose (cGy) were 180.4 ± 242.3, 71.5 ± 52.7, 76.2 ± 58.8, 85.9 ± 70.5, 90.7 ± 70.1, mean heart dose (cGy) were 285.8 ± 87.2, 221.2 ± 62.8, 274.5 ± 95.5, 234.8 ± 73.8, 263.2 ± 81.6, V20 for ipsilateral lung were 15.4 ± 5.3, 14.3 ± 3.6, 15.3 ± 2.9, 14.2 ± 3.9, 14.7 ± 3.2 and V5 for ipsilateral lung were 33.9 ± 8.2, 31.0 ± 3.5, 42.6 ±15.6, 36.4 ± 12.9, 37.0 ± 7.5.

Conclusion:The study concluded that appropriate arc span used for tangential intact breast treatment was optimally 30° because larger arc span were giving lower isodose spill in ipsilateral lung and smaller arc were giving heterogeneous dose distribution in PTV.


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