Comparing Three Simultaneous Integrated Boost Techniques in Breast Radiotherapy Planning: A Dosimetric Analysis
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Boosting whole-breast irradiation (WBI) has proven effective in reducing the risk of local recurrence in breast cancer treatment. Simultaneous Integrated Boost (SIB) techniques are gaining popularity for their efficiency in shortening treatment time. This study compares three SIB techniques in breast irradiation to identify the optimal approach. Ten computed tomography (CT) scans from breast cancer patients (five right-sided and five left-sided) were used to create three mono-isocentric SIB plans: (1) Volumetric Modulated Arc Therapy (F-VMAT), (2) Three-Dimensional Conformal Radiotherapy (F-3DCRT), and (3) a hybrid technique combining 3DCRT and VMAT (HYBRID). Plan quality was evaluated based on target volume coverage, organ-at-risk (OAR) sparing, and delivery time. Results showed that HYBRID provided the best target coverage, while F-VMAT provided the best conformity, with conformity indices of 1.50 ± 0.24, 1.40 ± 0.38, and 2.5 ± 1.18 for HYBRID, F-VMAT, and F-3DCRT, respectively (p < .001). For ipsilateral lung sparing, HYBRID and F-3DCRT outperformed F-VMAT in both V16Gy and V4Gy, while F-VMAT demonstrated higher V4Gy in the contralateral lung and heart V8Gy in left-sided tumors. In conclusion, the HYBRID technique provides a balanced approach, offering adequate target coverage and OAR sparing with minimal impact on treatment time, making it a viable option for optimizing breast cancer radiotherapy.
