USEFULNESS OF SIMPLE SHIELDING TECHNIQUE USING MULTILEAF COLLIMATOR IN BREAST RADIATION THERAPY
Lee, Kyu Chan;Lee, Seok Ho;Lee, Seung Heon;Sung, Kihoon;Ahn, So Hyun;Choi, Jinho;Dong, Kap Sang;Kim, Hyo Jin;Chun, Yong Seon;Park, Heung Kyu;
ABSTRACT
This study was designed to assess whether the conventional tangential technique, using a multileaf collimator (MLC), allows a reduced dose to the organs at risk (OAR) in breast radiation therapy. A total of forty right and left 20 for each breast cancer patients that underwent radiation therapy after breast conserving surgery were included in this study. For each patient, the planning target volume (PTV) and OAR (heart, left anterior descending artery (LAD), liver and lung) were defined and dose distribution were produced for conventional tangential beams using 6 MV photons. The treatment plans were made using the following two techniques for all patients. For the first plan (P1), MLC was designed to shield as much of OAR as possible without compromising the coverage of PTV. In the second plan (P2), the treatment plan was created without using MLC. Dose-volume histograms for OARs were calculated for all plans. For left breast cancer, the percentage of maximum dose ($D_{max%}$) and mean dose ($D_{mean%}$) of OARs (heart and LAD) were calculated, and for right breast cancer, the percentage of the mean dose ($D_{mean%}$) of the liver was calculated. The $D_{mean%}$ of the lung was calculated in all patients. The mean values of $D_{max%}$ of the heart ($86.9{pm}19.5%$ range, 35.1-100.6%) in P1 were significantly lower than in P2 ($98.3{pm}3.4%$ range, 91.7-105.2%) (p=0.001). The mean values of $D_{max%}$ of LAD ($78.4{pm}22.5%$ range, 26.5-99.7%) in P1 was significantly lower than in P2 ($93.3{pm}8.1%$ range, 67.9-102.1%) (p<0.001). In P1, the mean values of $D_{mean%}$ of the liver ($4.8{pm}2.0%$) were significantly lower than in P2 ($6.2{pm}2.5%$) (p<0.001). The mean values of $D_{mean%}$ of the lung were significantly lower in P1 ($9.3{pm}2.3%$) than in P2 ($9.7{pm}2.4%$) (p<0.001). P1, by using MLC, allows a significantly reduced dose to OAR compared with P2. We can suggest that it is reasonable to routinely use MLC in the conventional tangential technique for breast radiation therapy considering the primary tumor location.
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