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Authors: Francis C. Djoumessi Zamo, MSc ∗,†, Christopher F. Njeh, PhD, DABR, FAAPM ‡,1, Anthony Colliaux, PhD∗, Valérie Blot-Lafond, MSc ∗, M. Ndontchueng Moyo, PhD†
Synchronous bilateral breast cancers (SBBC) present a considerable issue in external beam radiotherapy because of large ?elds size and large target volumes. Monoisocentric volumetric modulated arc therapy (VMAT) appears as an appropriate irradiation technique for these types of tumors. The aim of this study was to demonstrate the utility of a 3D DVH pretreatment quality assurance program in VMAT of SBBC cases. Twenty SBBC patients who underwent radiation therapy in our department were retrospectively enrolled in this study. Fifteen patients were treated exclusively to the mammary glands. Five patients bene?ted from a dose boost on the tumor bed (60Gy). Nine patients were irradiated on the supraclavicular nodes (50Gy). This dose was delivered in 25 fractions and integrated boost was used when appropriate. Depending on the complexity of the treatment plans; 2 or 4 arcs VMAT plans were used in a monoisocentric technique. The patient speci?c quality assurance (PSQA) was evaluated using COMPASS measured data, COMPASS reconstructed (CR) and COMPASS computed (CC) dose compared to treatment planning system (TPS) dose. Clinical evaluation was based on DVH metrics for target volumes and organ at risks.
The maximum average dose deviation between TPS, CC, and CR was below 3%. The paired t-test between TPS, CC, and CR shows a strong agreement (p < 0.001). The 3DVH dose distribution comparison between TPS and COMPASS were also performed with good gamma score for global analysis.
COMPASS was successfully evaluated as a 3DVH pretreatment system for SBBC despite the large ?elds size and complex target volumes. It allows the veri?cation of the plan in 3D patient anatomy and the evaluation of dose discrepancies.
As of January 1, 2022, ARRT requires CE Credits for Directed Journal Readings to be based on the word count for each article. So, the number of CE Credits for each DJR article will vary for ARRT. For this article, the ARRT CE Credit will be 0.75 Credit. The MDCB CE Credits will remain at 2.5 Credits.
ARRT CQR Credit Distribution
Radiation Therapy 2017:
Procedures
Treatments = 1.0
Radiation Therapy 2022:
Procedures
Treatments = 1.0