Efficacy of Multiple Isocentric Volumetric Modulated Arc Therapy (VMAT) for Treatment of Bilateral Breast Carcinoma

  • Dr. Vikram Bali Rathore Ph D, Assistant Professor, Department of Radiotherapy, Regional Cancer Centre, Pt. J.N.M. Medical College, Jail Road, Raipur, Chhattisgarh, India
  • Dr. Pradeep Kumar Chandrakar MD, Assistant Professor, Department of Radiotherapy, Regional Cancer Centre, Pt. J.N.M. Medical College, Jail Road, Raipur, Chhattisgarh, India
  • Dr. Vivek Choudhary MD, Professor, Department of Radiotherapy, Regional Cancer Centre, Pt. J.N.M. Medical College, Jail Road, Raipur, Chhattisgarh, India
  • Dr Surendra Kumar Azad MD, Professor, Department of Radiotherapy, Regional Cancer Centre, Pt. J.N.M. Medical College, Jail Road, Raipur, Chhattisgarh, India
  • Dr Manjula Kerketta Assistant Professor, Department of Radiotherapy, Regional Cancer Centre, Pt. J.N.M. Medical College, Jail Road, Raipur, Chhattisgarh, India
Keywords: AAA, Bilateral Breast Cancer, PRO, VMAT

Abstract

Treating bilateral breast cancer with radiotherapy by conventional techniques is difficult because it requires multiple field settings from different orientations resulting in hot and cold spots at field junctions. Planning with Volumetric Modulated Arc therapy gives uniformity in dose distribution, minimizing hot and cold spots resulting in high doses to target and minimum dose to normal tissues. Volumetric Modulated Arc Therapy (VMAT) has been done on a patient with bilateral breast Cancer with two isocentres and dual half arcs in each isocentre. Mean dose achieved to PTV (Planning Target Volume) was 50Gy. The values of Conformity index (CI) and Homogeneity index (HI) were found to be 1.2 and 1.9 respectively. Maximum doses to lung, liver and heart were found in the region close proximity to the target. VMAT is found to be better technique for treating bilateral breast cancer. Post radiotherapy follow up at two years showed complete control of both primaries without any systemic recurrence and significant side effects.

Downloads

Download data is not yet available.

References

1. Boyle P, Howel A, The globalisation of breast cancer. Breast Cancer Res. 2010 Dec 20;12 Suppl 4:S7. doi: 10.1186/bcr2736. [PubMed]

2. Akarolo Anthony SN, Ogundiran TO, Adebamowo CA, Emerging breast cancer epidemic: Evidence from Africa. Breast Cancer Res. 2010 Dec 20;12 Suppl 4:S8. doi: 10.1186/bcr2737. [PubMed]

3. Mallath MK et al. Cancer burden and health system in India, The growing burden of cancer in India: Epidemiology and social context. The Lancet Oncology 2014;15[6]:e205-212. doi.org/10.1016/S1470-2045(14)70115-9. [PubMed]

4. Recht A, Breast Cancer: Stages T1 and T2 ln: Gunderson LL, Tepper JE editors 2nd ed. Clinical Radiation Oncology. Elsevier Publication. Churchill Livingstone 2007: 1475-1495.

5. Cuzick J, Stewart H, Rutavist L, Houghton J, Edwards R, Redmand C, et al. Cause specific mortality in long-term survivors of breast cancer who participated in trails of Radiotherapy. J Clin Oncol. 1994 Mar;12(3):447-53. [PubMed]

6. Gagliardi G, Lax I, Ottolenghi A, Rutqvist LE. Long term cardiac mortality after radiotherapy of breast cancer –application of the relative seriality model. Br J Radiol. 1996 Sep;69(825):839-46. [PubMed]

7. Rutqvist LE, Lax I, Fomander T, Johansson H. Cardiovascular mortality in a randomized trial of adjuvant radiation therapy versus surgery alone in primary breast cancer. Int J Radiat Oncol Biol Phys. 1992;22(5):887-96.

8. Intensity modulated radiotherapy collaborative working group. Intensity Modulated Radiotherapy: Current status and issues of interest. Int.J. Radiat. Oncol. Biol. Phys.2001Nov.15; 51(4): 880-914.doi.org/10.1016/S0360-3016(01)01749-7.

9. Popescu CC, Olivotto IA, Beckham WA et al., Volumetric modulated arc therapy improves dosimetry and reduces treatment time compared to conventional intensity-modulated radiotherapy for locoregional radiotherapy of left -side breast cancer and internal mammary nodes. Int. J. Radiat. Oncl. Biol.Phys. 2010 Jan; 76(1):287-295. doi.org/10.1016/j.ijrobp.2009.05.038.
CITATION
DOI: 10.17511/ijmrr.2015.i5.101
Published: 2015-06-30
How to Cite
1.
Bali Rathore V, Kumar Chandrakar P, Choudhary V, Kumar Azad S, Kerketta M. Efficacy of Multiple Isocentric Volumetric Modulated Arc Therapy (VMAT) for Treatment of Bilateral Breast Carcinoma. Int J Med Res Rev [Internet]. 2015Jun.30 [cited 2024Jul.3];3(5):535-7. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/273
Section
Case Report