[Potential indications for helical tomotherapy in breast cancers]

Area of Science:

• Radiation Oncology
• Medical Physics

Background:

• Postoperative breast cancer management often requires radiation therapy to reduce recurrence risk.
• Conformal radiotherapy (CRT) is a standard technique, but may have limitations in complex cases.
• Intensity-modulated radiation therapy (IMRT) offers potential advantages in dose distribution.

Purpose of the Study:

• To evaluate the dosimetric advantages of IMRT compared to CRT.
• To assess improvements in planning target volume (PTV) coverage and organs at risk (OARs) sparing.
• To identify specific patient subgroups that benefit most from IMRT in postoperative breast cancer.

Main Methods:

• Prospective dosimetric comparison of IMRT and monoisocentric CRT.
• Evaluation of nine postoperative breast cancer patient cases.
• Analysis of conformity, homogeneity, and coverage indices for PTVs and OARs.

Main Results:

• IMRT demonstrated superior dosimetric performance in all evaluated cases.
• Improvements were observed in at least one conformity, homogeneity, or coverage index for PTVs and OARs.
• IMRT was consistently selected over CRT due to its dosimetric benefits.

Conclusions:

• IMRT offers significant dosimetric gains for postoperative breast cancer patients.
• Indications for IMRT include bilateral lesions, pectus excavatum, prior thoracic irradiation, and complex anatomy (e.g., obese patients).
• IMRT should be considered for complex cases to optimize treatment efficacy and minimize toxicity.