Breast Conserving Treatment for Breast Cancer: Dosimetric Comparison of Sequential versus Simultaneous Integrated Photon Boost
Table 3
Summary of dosimetric evaluation.
Sequential boost
SIB
Significant (ANOVA)
CMS
Helical TomoTherapy
TomoDirect
# violation EVboost coverage
1
2
1
1
No
# violation EVbreast coverage
2
1
0
0
No
# CI ≥ 50%
0
9
3
5
Yes ()
Vol107 ipsilateral breast (cc)
463.32 (139.50–724.95)
230.47 (90.92–442.41)
346.61 (118.29–605.28)
365.15 (179.19–767.29)
Yes ()
Dmean heart left sided (Gy)
3.04 (1.30–7.35)
3.12 (1.61–7.66)
2.97 (1.59–6.89)
4.49 (1.84–8.95)
No
V5 heart left sided (%)
9.61 (3.66–23.72)
10.10 (4.29–24.70)
9.91 (2.54–25.65)
16.50 (4.82–27.27)
No
V20 heart left sided (%)
3.65 (0.83–13.20)
3.65 (0.81–13.28)
2.85 (0.00–11.10)
5.98 (0.65–15.32)
No
V30 heart left sided (%)
2.55 (0.15–10.49)
2.55 (0.04–10.60)
1.44 (0.00–6.73)
3.74 (0.32–11.79)
No
D2 heart right sided (Gy)
2.04 (1.25–3.72)
3.34 (1.17–9.52)
1.85 (1.29–2.38)
4.30 (1.11–11.52)
No
V20 ipsilateral lung (%)
10.95 (6.63–16.48)
11.15 (6.63–16.71)
10.32 (0.00–13.84)
11.33 (6.02–17.26)
No
V5 ipsilateral lung (%)
20.89 (12.59–28.87)
24.96 (12.66–47.32)
21.89 (4.36–28.49)
30.45 (16.42–61.51)
No
Dmean ipsilateral lung (Gy)
6.26 (3.69–8.64)
6.72 (3.73–9.20)
6.13 (2.15–7.96)
7.24 (4.85–11.14)
No
Dmean contralateral breast (Gy)
0.36 (0.03–1.25)
0.44 (0.14–1.45)
1.17 (0.27–3.60)
0.46 (0.18–0.56)
Yes ()
D2 contralateral breast (Gy)
2.26 (0.16–12.93)
2.39 (0.40–12.96)
4.61 (0.86–19.46)
1.19 (0.52–1.50)
No
In case more than 1 value is given, the first number is the mean value; the numbers between brackets are the minimum and maximum values. D2: near-maximum dose, as a surrogate for the point maximum dose as suggested in the ICRU Report 83 [21].
