Application of artificial intelligence for breast cancer classification before radiatiotherapy
J.L. Lopez Guerra, R. Gozalez, C. Parra, A. Martinez, A. Moreno, J. Peinado, Vladimir Suarez, María Muñoz Cabeza, B. Quintana, M. Fernandez, María José Ortiz · Reports of Practical Oncology & Radiotherapy · 2013
Backgruond.Three-dimensional conformal radiotherapy (3D-CRT) in the planning treatment of locorregional breast cancer including the internal mammary chain is realized, in our centre, by using tangential fields with multisegments; and PA-AP fields for nodal areas.Helical Tomotherapy (HT) is a sort of intensity-modulated radiation therapy, that uses an integrated CT scanner during radiation which is performed helicoidally.Purpose.To compare the dosimetric distribution of two breast radiotherapy plans: three-dimensional conformal radiotherapy vs. Helical Tomotherapy.Methods and materials.Six patients with stage IIIC breast cancer affecting internal mammary chain (clinically and/or histologically confirmed), were included in this study.For each patient, treatment plans were generated to compare the three-dimensional conformal radiotherapy (3D-CRT) against the Helical Tomotherapy (HT).CT simulation was performed in supine position with both arms above head and external rotation.The planning target volumes (PTV) included the chest wall/whole breast, supraclavicular, axillary, and internal mammary chain nodes.Dose prescription was 50.4 Gy, in 28 fractions of 1.8 Gy, to the PTV.Results.The average V20 and V5 for heart was 7.28% and 84.94% for HT vs. 2.73% and 8.18% for 3D-CRT.The average V30, V20 and V5 for ipsilateral lung was 19.66%, 31.47% and 92.61% for HT vs. 33.78%,38.41% and 54.82% for 3D-CRT.The average percentage of the contralateral lung receiving ≥5 Gy was 62.41% for HT and 2.86% for 3D-CRT.The average percentage of the contralateral breast receiving ≥5 Gy was 50.33% for HT and 8.18% for 3D-CRT.Conclusion.Tomotherapy decreases high dose irradiation in lung at the expense of a greater volume of lung and heart receiving low-dose irradiation and higher irradiation of contralateral breast and lung.The choice of treatment plan must be individualized for each patient based on doses in heart, and contralateral breast and lung.