Optimum Treatment Planning Technique Evaluation for Synchronous Bilateral Breast Cancer with Left Side Supraclavicular Lymph Nodes

Document Type : Original Paper


1 Al-Amal Hospital for Radiotherapy and Nuclear Medicine, Baghdad, Iraq

2 Department of phsiology and medical physics, college of medicine, Alnahrain university, Iraq

3 University of Baghdad, College of Medicine, Baghdad Center for Radiation Therapy and Nuclear Medicine, Baghdad, Iraq

4 Al-Karkh University of Science / College of Science/ Medical Physics Department, Baghdad, Iraq.

5 Ministry of health and environment/medical city / Baghdad Center for radiotherapy and nuclear medicine, Baghdad, Iraq

6 Ministry of health and environment/medical city / Baghdad Center for radiotherapy and nuclear medicine, Baghdad,Iraq

7 Ministry of health and environment/medical city / Baghdad Center for radiotherapy and nuclear medicine,Baghdad, Iraq

8 Department of Radiation Therapy, Faculty of Medicine, Aswan University, Aswan, Egypt.


Introduction: Bilateral breast cancer cases are classified as complex in radiotherapy treatment, especially those with the left side mastectomy and right-side lumpectomy with left side supraclavicular lymph nodes patients. The purpose of this study is to find the optimum treatment planning technique among the three available techniques: 3Dimentional conformal Radiotherapy (3D-CRT), Intensity modulated radiation therapy (IMRT), and Volumetric Modulated Arc Therapu (VMAT).
Material and Methods: Ten Bilateral breast cancer included in this study with left-side mastectomy and right-side lumpectomy with left-side supraclavicular lymph nodes. The patients are delineated by oncologists and prepared for radiation planning by MONACO 5.1 treatment planning system (TPS) with an X-ray photon beam of 6 MV or 10 MV energy using ELEKTA‏’‏s Agility linear accelerator. The prescribed dose is set at 4005 cCy per 15 fractions. Statistically with anova test among each other.
Results: The treatment with 3D-CRT, IMRT, and VMAT show a significant difference in the results. VMAT gives high dose distribution for the left mastectomy breast and its regional supraclavicular lymph nodes, while the IMRT gives a higher value for the right side breast with lumpectomy. The good homogeneity index is acquired with IMRT, while VMAT gives a better conformity index. The 3D-CRT planning technique lowers the dose to the heart and lunges better than the other techniques.
Conclusion: depending on the patient health and stage, the optimum treatment planning is applied. VMAT and IMRT give effective results than the 3D-CRT.  


Main Subjects

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Volume 18, Issue 6
November and December 2021
Pages 414-420
  • Receive Date: 02 June 2020
  • Revise Date: 18 October 2020
  • Accept Date: 09 November 2020