Evaluation of 3D-CRT Radiotherapy Treatment Planning with Radiobiological Effects in Patient-Specific 3D Printed Anthropomorphic Phantom Postmastectomy Breast Cancer Axillary Metastases

Document Type : Original Paper


1 Department of Physics, Institut Teknologi Sepuluh Nopember, Kampus ITS - Sukolilo Surabaya 60111, East Java, Indonesia.

2 Medical Physicist of Radiotherapy Installation, Naval Hospital Dr. Ramelan, Surabaya 60244, East Java, Indonesia



Background and purpose: There are still challenges in quality assurance and control of breast cancer radiotherapy treatments due to the inability to use dosimeters and a homogeneous phantom equivalent to water in a generic form. Therefore, this study aimed to evaluate and measure the effectiveness of a particular radiotherapy treatment planning system, namely 3D-CRT, and radiobiological effects in postmastectomy breast cancer axillary lymph metastases using a patient-specific 3D printed anthropomorphic phantom of the right breast after surgery.

Material and Methods: The chest wall and axilla were the two treatment targets for 3D-CRT planning techniques. Each target was subjected to variations of two and three irradiation fields, with a dose of 50.00 Gy and fractionation of 2.00 Gy. From the variations, the radiation dose received by PTV-CW, PTV-Ax, and OARs was evaluated to determine the best planning technique through dosimetry verification. The TLD100 Chip and EBT3 film were employed to measure the radiation dose at the PTV and OARs.

Results: According to the results, the planning system evaluation based on DVH showed no significant difference (p = 0.993) between two and three irradiation fields in both the chest wall and axillary planning 3D-CRT technique. Additionally, NTCP for OARs has values below 5%, while the smallest value was obtained for the left lung. Finally, the point dose verification between planning and measurement using TLD100 and EBT3 film indicated an average difference of 9.14% and 4.34%, respectively, with no significant difference.

Conclusion: This study successfully demonstrated the dosimetry evaluation and radiobiological effects of postmastectomy right breast cancer treatment using a patient-specific 3D printed anthropomorphic phantom, which met the established standards.


Main Subjects

Articles in Press, Accepted Manuscript
Available Online from 12 February 2024
  • Receive Date: 23 July 2023
  • Revise Date: 03 October 2023
  • Accept Date: 12 February 2024