Comparing the robustness of different skin flash approaches using wide tangents, manual flash VMAT, and simulated organ motion robust optimization VMAT in breast and nodal radiotherapy.

ABSTRACT: Compare the robustness of wide tangents (WT) and volumetric modulated arc therapy (VMAT) using different skin flash approaches in breast and nodal radiotherapy. Ten patients treated with WT using 2-cm flash were replanned with VMAT using no flash (NF), manual 2-cm flash (MF), and robust optimization (RO). Plan robustness was assessed for target coverage and organs at risk (OAR) by recalculating on 5 deformed CT scans (SOM1-5), daily cone beam (CBCT), and by shifting the isocenter 5 mm. VMAT NF gave poor coverage of CTVp with its smallest change of -3.2% for V_38Gy on CBCT. VMAT RO plans showed the least variations in target coverage loss compared to WT and VMAT MF which dropped as anatomical swelling increased. CTVp D_0.5cc decreased on CBCT and increased most for VMAT

SUBMITTER: Gleeson I 

PROVIDER: S-EPMC7613212 | biostudies-literature | 2022 Autumn

REPOSITORIES: biostudies-literature