Second Cancer Risk after simultaneous integrated boost radiation therapy of right sided breast cancer with and without flattening filter
- Background The aim of this study was to investigate if the flattening filter free mode (FFF) of a linear accelerator reduces the excess absolute risk (EAR) for second cancer as compared to the flat beam mode (FF) in simultaneous integrated boost (SIB) radiation therapy of right-sided breast cancer. Patients and methods Six plans were generated treating the whole breast to 50.4 Gy and a SIB volume to 63 Gy on CT data of 10 patients: intensity-modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT), and a tangential arc VMAT (tVMAT), each with flattening filter and without. The EAR was calculated for the contralateral breast and the lungs from dose-volume histograms (DVH) based on the linear-exponential, the plateau, and the full mechanistic dose-response model. Peripheral low-dose measurements were performed to compare the EAR in more distant regions as the thyroids and the uterus. Results FFF reduces the EAR significantly in the contralateral and peripheral organs for tVMAT and in the peripheral organs for VMAT. No reduction was found for IMRT. The lowest EAR for the contralateral breast and lung was achieved with tVMAT FFF, reducing the EAR by 25 % and 29 % as compared to tVMAT FF, and by 44 % to 58 % as compared to VMAT and IMRT in both irradiation modes. tVMAT FFF showed also the lowest peripheral dose corresponding to the lowest EAR in the thyroids and the uterus. Conclusion The use of FFF mode allows reducing the EAR significantly when tVMAT is used as the treatment technique. When second cancer risk is a major concern, tVMAT FFF is considered the preferred treatment option in SIB irradiation of right-sided breast cancer.
Verfasserangaben: | Barbara DoblerORCiD, Johannes Maier, Bernadette Knott, Manuel Maerz, Rainer LöschelGND, Oliver Kölbl |
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DOI: | https://doi.org/10.1007/s00066-016-1025-5 |
Titel des übergeordneten Werkes (Englisch): | Strahlentherapie und Onkologie |
übersetzter Titel (Deutsch): | Sekundärmalignom-Risiko nach simultan integrierter Boost-Bestrahlung des rechtsseitigen Mamma-Karzinoms mit und ohne Ausgleichskörper |
Verlag: | Springer Nature |
Verlagsort: | Heidelberg |
Dokumentart: | Artikel aus einer Zeitschrift/Zeitung |
Sprache der Veröffentlichung: | Englisch |
Jahr der Veröffentlichung: | 2016 |
Datum der Freischaltung: | 06.04.2022 |
Freies Schlagwort / Tag: | 3D-CRT; Breast Cancer; CONTRALATERAL BREAST; DOSES RELEVANT; HODGKIN COHORTS; IMRT; INDUCTION; JAPANESE A-BOMB; PREDICTED RISK; Peripheral Dose; Radiotherapy; Second Cancer Risk; VMAT; flattening filter free |
Jahrgang: | 192 |
Ausgabe / Heft: | 10 |
Erste Seite: | 687 |
Letzte Seite: | 695 |
Fakultäten / Institute / Einrichtungen: | Fakultät Informatik und Mathematik |
Begutachtungsstatus: | peer-reviewed |
Forschungsschwerpunkt: | Lebenswissenschaften und Ethik |
Lizenz (Deutsch): | Keine Lizenz - Es gilt das deutsche Urheberrecht: § 53 UrhG |