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Dosimetric evaluation of hybrid and volumetric-modulated arc therapy plan for left-sided chest wall irradiation in MONACO treatment planning system


1 Department of Radiation Physics, Kidwai Memorial Institute of Oncology, Sri Shankara Cancer Foundation, Bengaluru, Karnataka, India
2 Department of Radiotherapy, Sri Shankara Cancer Foundation, Bengaluru, Karnataka, India

Correspondence Address:
P Senthil Manikandan,
Department of Radiation Physics, Kidwai Memorial Institute of Oncology, Bengaluru - 560 029, Karnataka
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.JCRT_707_20

Background and Objective: Radiation induced toxicities in heart and lungs are diminishes the survival rate of cancer patients. The purpose of this study is to evaluate the dosimetric parameters of hybrid plans for chest wall irradiation of left breast carcinoma patients using Monaco treatment planning system and compare with the volumetric-modulated arc therapy (VMAT) treatment plans. Materials and Methods: Fifteen carcinoma left breast patients were randomly selected to evaluate the advantage of hybrid plan over VMAT. Hybrid plans were generated with 70% and 30% dose contribution from forward intensity-modulated radiotherapy and VMAT, respectively, whereas VMAT had been done with full prescription. Conformity and homogeneity indices were evaluated for target coverage between hybrid and VMAT plans. Results: Hybrid plan has proved its superiority over VMAT in terms of better organ at risk sparing and lesser low dose spillage and at the same time providing comparable target coverage. In low-dose spectrum, VMAT showed higher dose–volume than the hybrid plan. The maximum variation was found to be 44.75% at 7 Gy and the minimum dose difference was observed at 1 Gy (6.02%). Conclusion: This study suggests that the hybrid plan could be a better option for left-sided chest wall irradiation in regular clinical practice.


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