2Department of Medical Oncology, Tokat Gaziosmanpaşa University Faculty of Medicine, Tokat-Türkiye
3Department of Radiation Oncology, Ankara Memorial Hospital, Ankara-Türkiye
4Department of Radiation Oncology, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara-Türkiye DOI : 10.5505/tjo.2022.3504 OBJECTIVE
The aim of this study was to compare tangential field field-in-field (FIF) and dynamic-intensity-modulated radiotherapy (d-IMRT) techniques in terms of changes in cardiac substructure and coronary arteries doses on dose-volume histogram (DVH).
METHODS
Fifteen patients with the left breast cancer who received radiotherapy to the chest wall (CW) were retrospectively
selected. The left main coronary artery, left anterior descending (LAD), circumflex and right
coronary arteries, and heart chambers were contoured. Dmean, V5, V10, and V30 for heart chambers; Dmean
and Dmax for coronary vessels; and Dmean, V95, V107, CI and HI for planned target volume were compared
between plans on DVH.
RESULTS
When the internal mammary lymph node (IMLN) field is added to the CW, high-dose volumes of the
whole heart and ventricles (V30) and LAD doses are significantly better protected with d-IMRT technique
(whole heart V30: 9.4% by 6.2%, ventricle L V30: 17.1% by 9.9%, ventricle R V30: 7.3% by 4.3%, and
LAD Dmax: 52.7 Gy by 51 Gy). All the low-dose volumes of the whole heart and ventricles (V5 and V10)
and all coronary vessels excepting LAD were better protected in the FIF technique.
CONCLUSION
In patients who will undergo IMLN radiotherapy, especially if they have coronary disease, RT technique can be selected according to the vessel where the damage is located. However, more research is warranted
on this subject.