Iranian Journal of Medical Physics

Iranian Journal of Medical Physics

Intensity-Modulated Radiation Therapy (IMRT) Versus Rapidarc in the Treatment of Carcinoma Left Breast – Finding the Optimal Radiation Therapy Technique

Document Type : Original Paper

Authors
Preety Negi 1
Raja Sellapandiyan 2
Himanshu Srivastava 1
Harnoor Singh Pruthi 3
Gokul Anandhan 4
Priyanka Singh 5
1 Consultant Radiation Oncologist, Capitol hospital, Jalandhar, Punjab, India
2 Medical Physicist and RSO, Capitol hospital, Jalandhar, Punjab, India
3 Consultant Cardiologist, Department of Cardiology, Capitol hospital, Jalandhar, Punjab, India
4 Medical Physicist, Capitol hospital, Jalandhar, Punjab, India
5 DNB Resident, Department of Radiation Oncology, Capitol hospital, Jalandhar, Punjab, India
10.22038/ijmp.2023.69251.2218
Abstract
Introduction: This study aimed to evaluate the dosimetric variations and treatment efficacy between intensity-modulated radiotherapy (IMRT) and double-arc RapidArc for irradiation of carcinoma left breast, focusing on adequate target coverage, sparing of organs at risk (OARs), delivered monitor units (MUs) per fraction, and treatment delivery time.
Material and Methods: This prospective, observational study was conducted on 30 patients with carcinoma left breast. All these patients were treated with adjuvant radiation therapy.  We generated two plans for each of these patients: IMRT and double-arc RapidArc technique. The target volume and OARs were analyzed using dose-volume histograms (DVHs). The average MUs and the treatment time were used as markers to assess the efficacy of treatment delivery.
Results: The planning target volume parameters such as homogeneity and conformity index were similar for all the plans with both techniques. With IMRT, statistically significantly better sparing of I/L lung, heart, C/L breast, C/L lung, and esophagus were achieved as compared to RapidArc. We found that RapidArc resulted in significantly lower MUs (535.05 ± 105.42) than IMRT (913.57 ± 129.35). Treatment delivery time was statistically shorter with RapidArc as compared to IMRT (p=0.001). 
Conclusion: This study concluded that both IMRT and RapidArc plans have similar target coverage in terms of homogeneity and conformality indexes. Better OARs sparing was noticed with IMRT while RapidArc enabled higher efficacy with lower MUs and shorter treatment delivery time. However, further studies are needed to establish these dosimetric advantages being translated to improvements in the clinical outcomes of these patients. 
Keywords
Breast Neoplasms
Esophagus
IMRT
Organs at Risk
Radiotherapy
RapidArc
Subjects
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Iranian Journal of Medical Physics
Volume 20, Issue 6 - Serial Number 6
November and December 2023
Pages 359-365

  • Receive Date 29 November 2022
  • Revise Date 27 February 2023
  • Accept Date 10 March 2023