Abstract

Background: The objective of the study is to compare Forwarded IMRT FiF plan with Enhance Dynamic Wedge (EDW) tangential field radiotherapy in terms of dosimetric benefits for OARs early stage left side breast cancer radiotherapy. Materials and Methods: Twenty patients of consecutive left side breast cancer who underwent breast conserving surgery were included and without surgery patients were also included in the study. Two different methods of treatment plans were created for the entire left side breast cancer patients. Forwarded IMRT Field in Field plans (FiF) plan and Enhance Dynamic Wedge (EDW) planning’s are compared for doses in the planning target volume (PTV), the organs at risk (OARs) volume including ipsilateral lung, heart, left ascending coronary artery (LAD) and the contralateral breast, the dose homogeneity index (DHI), conformity index (CI) and the monitor units (MUs) counts required for the treatment. Results: The homogeneity conformity of the dose to planning target volume (PTV) and the dose delivered to the heart, contralateral breast, and left ascending coronary artery (LAD) were compared with two techniques in all the 20 patients. Both the radiotherapy techniques achieved comparable radiation dose delivery to PTV-95% of the prescribed dose covering > 95% of the breast PTV as well as the mean doses of the heart, ipsilateral lung, contralateral lung, aorta, left atrium, right atrium, left ventricle, right ventricle, contralateral breast. Forwarded IMRT FiF technique achieving better uniform dose distribution and conformity with lower doses to OARs and less MUs. Conclusion: The Forwarded IMRT FiF technique achieving better dose distribution in the PTV and spare the OARs. The lesser MUs required for treatment of the Forwarded IMRT FiF technique seems to be more advantageous compared to the Enhance Dynamic Wedge plan during whole left side breast irradiation

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