Introduction: The aim of radiotherapy (Rth) is to provide optimal dose to the
target with the least dose to surrounding risk structures. Intensity-modulated
radiation therapy (IMRT) intends to improve the reach of optimal dose
conformity to the target with the least risk structure dose. The aim of the study
is to compare dose to the target and risk structures using (IMRT) and 3D
conformal radiotherapy (3DCRT) for adjuvant left breast cancer.
Methods: This study included 20 localized unilateral breast cancer patients
treated for adjuvant 3DCRT in the Aswan Cancer Centre. The treatment was
planned for 3DCRT and then another plan for IMRT later on for the purpose of
this dosimetric study. We compared both plans for target structure coverage,
risk structure, and number of monitor units.
Results: PTV total V95% was significantly better for IMRT vs. 3DCRT
(92.2%) vs. 88% (p = 0.025). The conformity index was also significantly
superior for IMRT planning. The other parameters for PTV total coverage and
homogeneity index showed no significant difference between both techniques.
IMRT insignificantly reduced the mean heart dose, 2.6 Gy for IMRT vs. 3.2 Gy
for conformal (p = 0.368). It was also observed that the IMRT plans achieved a
lower left lung dose than the conformal ones, i.e., 7.7 Gy vs. 7.9 Gy (p = 0.38).
Contralateral breast mean and D5 doses were significantly lower in favour of
3DCRT vs IMRT (0.7 vs. 1.1 and 0.1 vs. 0.8; P values =0.01 and 0.043)
respectively.
Conclusion: Overall, IMRT achieved superior dose parameters and marginally
better risk structures sparing than 3D-CRT. However, contralateral breast mean
and D5 doses were significantly better in favour of conformal planning.