Comparison of different radiotherapy planning techniques in breast cancer using active breathing coordinator
4 affiliations
- 1Medical Biophysics, Department of Physics, Faculty of Science, Helwan University, Cairo, Egypt
- 2Medical Physics Department, Maadi Military Hospital and Air Force Specialized Hospital, Cairo, Egypt
- 3Clinical Oncology Department, Kasr Alainy Center of Clinical Oncology, Cairo University, Cairo, Egypt
- 4School of Applied Health Sciences, Badr University in Cairo (BUC), Badr City, Egypt
Abstract
BACKGROUND: To identify the optimal radiotherapy planning technique that provides the best dosimetric outcomes in terms of target coverage and sparing of organs at risk (OAR) when using deep inspiration breath-holding (DIBH) for early left-sided breast cancer treatment. MATERIALS AND METHODS: Thirty patients with early-stage left-sided BC had previously been simulated and treated with DIBH using the active breathing coordinator (ABC) system. Each patient underwent replanning using 3D conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), and volumetric-modulated arc therapy (VMAT) techniques with a prescription dose of 40.05 Gy over 15 fractions. The planning target volume (PTV) and OARs were evaluated using dose-volume histograms (DVH). Dosimetric parameters [V₉₅, D₉₈, D₅₀, D₂, V₁₀₇, conformity index (CI), homogeneity index (HI)], and OAR metrics for the heart, left anterior descending artery (LAD), lungs, and contralateral breast were analysed statistically. RESULTS: VMAT achieved the best PTV coverage and homogeneity (HI = 0.1). The mean heart dose was lowest for 3DCRT (1.9 Gy) and VMAT (2 Gy), whereas for the LAD VMAT achieved the lowest doses (Dₘₑₐₙ = 5.2 Gy; Dₘₐₓ = 17.3 Gy; p < 0.001). For the ipsilateral lung, 3DCRT offered superior low-dose sparing, while VMAT minimised high-dose exposure. Contralateral lung and breast doses were lowest with 3DCRT. CONCLUSIONS: VMAT offers superior target conformity and cardiac sparing, specifically for the LAD, whereas 3DCRT minimises contralateral organs and low-dose lung exposure. These findings highlight the necessity for personalised treatment, whether the priority is to limit cardiac toxicity or reduce low-dose exposure to the patient.
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BibTeX
@article{farid2026comparison,
title = {{Comparison of different radiotherapy planning techniques in breast cancer using active breathing coordinator}},
author = {Yara G. Farid and Mohamed S. Ibrahim and Medhat W. Shafaa and Noha A. Rahmoun and Magdy M. Khalil and Khalid A. Khalil},
journal = {Reports of Practical Oncology and Radiotherapy},
year = {2026},
month = nov,
doi = {10.5603/rpor.113430},
url = {https://doi.org/10.5603/rpor.113430},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Comparison of different radiotherapy planning techniques in breast cancer using active breathing coordinator
AU - Yara G. Farid
AU - Mohamed S. Ibrahim
AU - Medhat W. Shafaa
AU - Noha A. Rahmoun
AU - Magdy M. Khalil
AU - Khalid A. Khalil
PY - 2026
DA - 2026/11/02
JO - Reports of Practical Oncology and Radiotherapy
DO - 10.5603/rpor.113430
UR - https://doi.org/10.5603/rpor.113430
AB - BACKGROUND: To identify the optimal radiotherapy planning technique that provides the best dosimetric outcomes in terms of target coverage and sparing of organs at risk (OAR) when using deep inspiration breath-holding (DIBH) for early left-sided breast cancer treatment. MATERIALS AND METHODS: Thirty patients with early-stage left-sided BC had previously been simulated and treated with DIBH using the active breathing coordinator (ABC) system. Each patient underwent replanning using 3D conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), and volumetric-modulated arc therapy (VMAT) techniques with a prescription dose of 40.05 Gy over 15 fractions. The planning target volume (PTV) and OARs were evaluated using dose-volume histograms (DVH). Dosimetric parameters [V₉₅, D₉₈, D₅₀, D₂, V₁₀₇, conformity index (CI), homogeneity index (HI)], and OAR metrics for the heart, left anterior descending artery (LAD), lungs, and contralateral breast were analysed statistically. RESULTS: VMAT achieved the best PTV coverage and homogeneity (HI = 0.1). The mean heart dose was lowest for 3DCRT (1.9 Gy) and VMAT (2 Gy), whereas for the LAD VMAT achieved the lowest doses (Dₘₑₐₙ = 5.2 Gy; Dₘₐₓ = 17.3 Gy; p < 0.001). For the ipsilateral lung, 3DCRT offered superior low-dose sparing, while VMAT minimised high-dose exposure. Contralateral lung and breast doses were lowest with 3DCRT. CONCLUSIONS: VMAT offers superior target conformity and cardiac sparing, specifically for the LAD, whereas 3DCRT minimises contralateral organs and low-dose lung exposure. These findings highlight the necessity for personalised treatment, whether the priority is to limit cardiac toxicity or reduce low-dose exposure to the patient.
SN - 1507-1367
SN - 2083-4640
ER -