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. 2023 Aug 18:13:1145332.
doi: 10.3389/fonc.2023.1145332. eCollection 2023.

Application of tangent-arc technology for deep inspiration breath-hold radiotherapy in left-sided breast cancer

Yucheng Li  1 , Wenming Zhan  1 , Yongshi Jia  1 , Hanchu Xiong  1 , Baihua Lin  1 , Qiang Li  1 , Huaxin Liu  1 , Lingyun Qiu  1 , Yinghao Zhang  1 , Jieni Ding  1 , Chao Fu  2 , Weijun Chen  1
Affiliations

Application of tangent-arc technology for deep inspiration breath-hold radiotherapy in left-sided breast cancer

Yucheng Li et al. Front Oncol. .

Abstract

Objective: To explore the advantages of dosimetry and the treatment efficiency of tangent-arc technology in deep inspiration breath-hold radiotherapy for breast cancer.

Methods: Forty patients with left-sided breast cancer who were treated in our hospital from May 2020 to June 2021 were randomly selected and divided into two groups. The first group's plan was a continuous semi-arc that started at 145° ( ± 5°) and stopped at 325° ( ± 5°). The other group's plan, defined as the tangent-arc plan, had two arcs: the first arc started at 145° ( ± 5°) and stopped at 85° ( ± 5°), and the second arc started at 25° ( ± 5°) and stopped at 325° ( ± 5°). We compared the target dose, dose in organs at risk (OARs), and treatment time between the two groups.

Results: The target dose was similar between the continuous semiarc and tangent-arc groups. The V5 of the right lung was significantly different between the two groups (Dif 5.52, 95% confidence interval 1.92-9.13, t=3.10, P=0.004), with the patients in the continuous semi-arc and tangent-arc groups having lung V5 values of (9.16 ± 1.62)%, and (3.64 ± 0.73)%, respectively. The maximum dose to the spinal cord was (1835.88 ± 222.17) cGy in the continuous semi-arc group and (599.42 ± 153.91) cGy in the tangent-arc group, yielding a significant difference between the two groups (Dif 1236.46, 95% confidence interval 689.32-1783.6, t=4.57, P<0.001). The treatment times was (311.70 ± 60.45) s for patients in the continuous semi-arc group and (254.66 ± 40.73) s for patients in the tangent-arc group, and there was a significant difference in the mean number of treatment times between the two groups (Dif 57.04, 95% confidence interval 24.05-90.03, t=3.5, P=0.001).

Conclusion: Both the continuous semi-arc and tangent-arc plans met the clinical prescription dose requirements. The OARs received less radiation with the tangent-arc plan than the continuous semi-arc plan, especially for the lung (measured as V5) and the spinal cord (measured as the maximum dose). Tangent-arc plan took significantly less time than the continuous semi-arc, which can greatly improve treatment efficiency. Therefore, tangent-arc plans are superior continuous semi-arc plans for all cases.

Keywords: continuous semi-arc; deep inspiration breath-hold; dosimetry; left breast cancer; organ of risk; tangent-arc.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(The left is the continuous semi-arc, the right is the tangent-arc, and green represents PTV).
See this image and copyright information in PMC

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