Using multiple techniques in radiation therapy of synchronous bilateral breast carcinoma

The purpose of this article is to shed light on the dosimetric benefits of volumetric modulated arc therapy (VMAT) in comparison with intensity-modulated radiotherapy (IMRT) and three- dimensional conformal radiotherapy (3D-CRT) for bilateral breast cancer radiotherapy in 9 patients with synchronous bilateral breast cancer. Seven patients with early bilateral breast cancer after breast conservation surgery, one patient after unilateral mastectomy and unilateral breast conservation surgery and one patient after bilateral mastectomy were planned for bilateral breast radiotherapy. On the planning computed tomography (CT) dataset, bilateral breast planning treatment volume (PTV) and organs at risk (OARs) were delineated using standard guidelines. Using the same structure set, VMAT, IMRT and 3DCRT plans were generated and compared dosimetrically. VMAT showed comparable target coverage, conformity and homogeneity, while effects on lungs and heart were gentler compared with two other methods. The dose to vessels was reduced by using VMAT.