Dosimetry Evaluations in Breast Cancer Using 3D-CRT Technique
Keywords:
Dose Volume Histogram (DVH), Conformity Index (CI), Homogeneity Index (HI), Breast Cancers
Abstract
Several previous studies have shown that without dose evaluation and monitoring, there is a potential for deterministic radiation effects in 3D-CRT procedures. This study is expected to close the gap by conducting a more comprehensive evaluation of the 3D-CRT technique for breast cancer patients. The research method is quantitative analysis with a study sample of 20 breast cancer patients. Data processing was carried out by conducting statistical tests for the distribution value of organs at risk (OAR) against the Radiation Therapy Oncology Group (RTOG) guidelines and analyzing the conformity index (CI) and homogeneity index (HI) values according to the values recommended by the International Commission Radiation Unit (ICRU). The results of this study obtained OAR doses for the lungs and heart are still within the tolerance value limits set by RTOG p-value <0.05. then for CI and HI there is a deviation p-value <0.05 that there is a difference between the values obtained and the ICRU recommended value. This is due to the location of the target or tumor adjacent to the OAR, to keep the OAR value in accordance with the specified limit value.
References
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[2] W. Farhiyati, R. Subroto, I. W. A. Makmur, N. Qomariyah, and R. Wirawan, “Treatment Planning System (TPS) Kanker Payudara Menggunakan Teknik 3DCRT,” vol. 6, pp. 150–154, 2020.
[3] M. Scharlier, “The elimination of cancer,” British Journal of Tuberculosis, vol. 1, no. 2, pp. 180–181, 1907, doi: 10.1016/S0366-0850(07)80117-7.
[4] U. L. Syifa Khairunnisa Hero, Program Studi Pendidikan Dokter, Fakultas Kedokteran, “Jurnal Medika Hutama,” vol. 03, no. 01, pp. 3–8, 2021.
[5] T. Taufiqurrahman, S. Rianto, and A. Nugroho Setiawan, “Comparative Analysis of Intensity Modulation Radiation Therapy and Volumetric Modulation Arc Therapy in Brain Tumor Cases to Minimize Radiation Dose to Organs at Risk,” International Journal of Social Health, vol. 2, no. 10, pp. 718–724, 2023, doi: 10.58860/ijsh.v2i10.111.
[6] S. Lutfiarahma, Y. W. Prajoko, F. H. Ningrum, and C. H. Nawangsih, “The Incidence of Radioation Pneumonitis In Breast Cancer Patients Who Received Radiotherapy Using 3-Dimensional Techniques,” vol. 11, pp. 217–220, 2022.
[7] J. E. S. (2020). Irna, “Komparasi Treatment Planning Berkas Foton Teknik 3 Dimensional – Conformal Radiation Therapy dan Intensity Modulated Radiation Therapy Untuk Kanker Payudara Kiri,” Prosiding Seminar Nasional Inovasi dan Pendayagunaan Teknologi Nuklir 2020, vol. ISBN 978-6, no. November, pp. 143–150, 2020.
[8] A. J. Medford, B. Moy, L. M. Spring, S. A. Hurvitz, N. C. Turner, and A. Bardia, “Molecular Residual Disease in Breast Cancer: Detection and Therapeutic Interception,” Clinical Cancer Research, vol. 29, no. 22, pp. 4540–4548, Nov. 2023, doi: 10.1158/1078-0432.CCR-23-0757.
[9] V. Hernandez et al., “What is plan quality in radiotherapy? The importance of evaluating dose metrics, complexity, and robustness of treatment plans,” Radiotherapy and Oncology, vol. 153, pp. 26–33, 2020, doi: 10.1016/j.radonc.2020.09.038.
[10] S. Aras, T. İkizceli, and M. Aktan, “Dosimetric Comparison of Three-Dimensional Conformal Radiotherapy (3D-CRT) and Intensity Modulated Radiotherapy Techniques (IMRT) with Radiotherapy Dose Simulations for Left-Sided Mastectomy Patients,” European Journal of Breast Health, vol. 15, no. 2, pp. 85–89, 2019, doi: 10.5152/ejbh.2019.4619.
[11] W. Muhammad, A. Hussain, and M. Maqbool, Basic Concepts in Radiation Dosimetry, no. February 2018. 2017. doi: 10.1007/978-3-319-61540-0_2.
[12] C. R. Hansen, M. Hussein, U. Bernchou, R. Zukauskaite, and D. Thwaites, “Plan quality in radiotherapy treatment planning – Review of the factors and challenges,” Journal of Medical Imaging and Radiation Oncology, vol. 66, no. 2, pp. 267–278, Mar. 2022, doi: 10.1111/1754-9485.13374.
[13] S. A. I. Al-Rawi et al., “Evaluation of Conformity and Homogeneity Indices Consistency Throughout the Course of Head and Neck Cancer Treatment with and Without Using Adaptive Volumetric Modulated Arc Radiation Therapy,” Advances in Radiation Oncology, vol. 7, no. 5, p. 100905, 2022, doi: 10.1016/j.adro.2022.100905.
[14] A. Kyroudi, K. Petersson, E. Ozsahin, J. Bourhis, F. Bochud, and R. Moeckli, “Exploration of clinical preferences in treatment planning of radiotherapy for prostate cancer using Pareto fronts and clinical grading analysis,” Physics and Imaging in Radiation Oncology, vol. 14, no. January, pp. 82–86, 2020, doi: 10.1016/j.phro.2020.05.008.
[15] D. Petrova, S. Smickovska, and E. Lazarevska, “Conformity index and homogeneity index of the postoperative whole breast radiotherapy,” Open Access Macedonian Journal of Medical Sciences, vol. 5, no. 6, pp. 736–739, 2017, doi: 10.3889/oamjms.2017.161.
[16] S. Adeneye et al., “Evaluation of Three-Dimensional Conformal Radiotherapy and Intensity Modulated Radiotherapy Techniques for Left Breast Post-Mastectomy Patients: Our Experience in Nigerian Sovereign Investment Authority-Lagos University Teaching Hospital Cancer Center, So,” European Journal of Breast Health, vol. 17, no. 3, pp. 247–252, 2021, doi: 10.4274/ejbh.galenos.2021.6357.
[17] O. Febrietri, D. Milvita, and F. Diyona, “Analisis Dosis Radiasi Paru-Paru Pasien Kanker Payudara dengan Teknik Three-Dimensional Conformal Radiation Therapy (3D-CRT) Berdasarkan Grafik Dose Volume Histogram (DVH),” Jurnal Fisika Unand, vol. 9, no. 1, pp. 110–117, 2020, doi: 10.25077/jfu.9.1.110-117.2020.
[18] E. Shaw et al., “Radiation therapy oncology group: Radiosurgery quality assurance guidelines,” International Journal of Radiation Oncology, Biology, Physics, vol. 27, no. 5, pp. 1231–1239, 1993, doi: 10.1016/0360-3016(93)90548-A.
[19] I. Report, “ICRU 62 (English),” no. November, pp. 357–360, 1993.
[20] N. Hodapp, “The ICRU Report No. 83: Prescribing, recording and reporting photon-beam intensity-modulated radiation therapy (IMRT),” Strahlentherapie und Onkologie, vol. 188, no. 1, pp. 97–99, 2012, doi: 10.1007/s00066-011-0015-x.
[21] P. Qingya, F. Yizhong, Z. Fuke, L. Shengjie, T. Linzhao, and L. Yuling, “Standard-Deviation Based Conformity Index for Evaluating Treatment Plan of Intensity Modulated Radiotherapy in Lung Cancer,” Radiation Protection Dosimetry, vol. 199, no. 2, pp. 87–94, 2023, doi: 10.1093/rpd/ncac228.
[22] G. Patel, A. Mandal, S. Choudhary, R. Mishra, and R. Shende, “Plan evaluation indices: A journey of evolution,” Reports of Practical Oncology and Radiotherapy, vol. 25, no. 3, pp. 336–344, 2020, doi: 10.1016/j.rpor.2020.03.002.
[23] M. Husni, M. A. Shafii, R. Adrial, and M. Ilyas, “Analisis Perbandingan Nilai Conformity Index dan Homogeneity Index pada Teknik 3D-CRT dan IMRT pada Kasus Kanker Payudara Berdasarkan Hasil TPS di RS UNAND,” Jurnal Fisika Unand, vol. 10, no. 4, pp. 511–517, 2021, doi: 10.25077/jfu.10.4.511-517.2021.
[24] S. Rudra, H. A. Al-Hallaq, C. Feng, S. J. Chmura, and Y. Hasan, “Effect of RTOG breast/chest wall guidelines on dose-volume histogram parameters,” Journal of Applied Clinical Medical Physics, vol. 15, no. 2, pp. 127–137, 2014, doi: 10.1120/jacmp.v15i2.4547.
[25] M. Azam, A. Agrawal, K. Sahni’s, S. Farzana, M. Rastogi, and A. Rathi, “Target volume coverage in clinically designed radiotherapy plan of post-mastectomy adjuvant radiotherapy of breast cancer patients in comparison with radiation therapy oncology group-based contoured plan: A dosimetric study,” Journal of Cancer Research and Therapeutics, vol. 14, no. 7, pp. 1525–1534, 2018, doi: 10.4103/jcrt.JCRT.
[26] G. Loganadane et al., “Comparison of Nodal Target Volume Definition in Breast Cancer Radiation Therapy According to RTOG Versus ESTRO Atlases: A Practical Review from the TransAtlantic Radiation Oncology Network (TRONE),” International Journal of Radiation Oncology Biology Physics, vol. 107, no. 3, pp. 437–448, 2020, doi: 10.1016/j.ijrobp.2020.04.012.
[27] M. I. S et al., “Analisis Perencanaan Radioterapi Menggunakan Teknik Intensity Modulated Radiotherapy (IMRT) pada Pasien Kanker Serviks,” vol. 12, no. 1, pp. 165–171, 2023.
[28] H. Liu, X. Chen, Z. He, and J. Li, “Evaluation of 3D-CRT, IMRT and VMAT radiotherapy plans for left breast cancer based on clinical dosimetric study,” Computerized Medical Imaging and Graphics, vol. 54, pp. 1–5, 2016, doi: 10.1016/j.compmedimag.2016.10.001.
[29] L. Begnozzi et al., “Quality assurance of 3D-CRT: Indications and difficulties in their applications,” Critical Reviews in Oncology/Hematology, vol. 70, no. 1, pp. 24–38, 2009, doi: 10.1016/j.critrevonc.2008.07.016.
Published
2025-01-21
How to Cite
AmbarsariL. I., IrsalM., SutoroS. G., ApriantoroN. H., WinarnoG., & LesmanaH. (2025). Dosimetry Evaluations in Breast Cancer Using 3D-CRT Technique. JPK : Jurnal Proteksi Kesehatan, 13(2), 233-241. https://doi.org/10.36929/jpk.v13i2.933
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Articles
