Özet:

Early stage breast cancer in accelerated partial breast radiation is aimed at comparing critical organs doses with target volume using Volumetric Ark Therapy (VMAT) and CyberKnife techniques. With the selection of patients diagnosed with early stage breast cancer receiving radiotherapy for this study, the daily fraction dose will be 6 Gy and the total dose will be 30 Gy, VMAT and CyberKnife (SBRT) virtual plans were created. The homogenity index (HI), conformity index (CI), treatment time (s), visible target volume (GTV) and the dose values received by critical organs were compared. Between the treatment plans, the value of GTV’s Dmax (p=0,002) found a significant difference in favour of the VMAT technique. 30 Gy (V30) (p=0,013) and 15 Gy (V15) volume values (p=0,007) of the same side breast were found to receive a lower dose in CyberKnife technique. There was no significant difference in the value of the opposite breast Dmax (p=0.218) . There was no significant difference in the volume of the heart’s Dmax (p=0,282) and 1.5 Gy (V1,5) (p=0,548). There was no significant difference in the value of the heart’s Dmax (p=0.095) in the left-must settled events, but the volume value of the heart’s 1.5 Gy area (V1,5) (p=0,008) was found lower in CyberKnife technique. The treatment time (s) (p<0,001) was significantly reduced in the VMAT technique. As a result, in both therapeutic techniques, the target volume takes the desired dose, but it is clear that the CyberKnife technique is superior in patients at risk in terms of reduction of late heart side effects, in early stages. In light of technological developments, CyberKnife technique can be assessed in appropriate circumstances as the current treatment approach for accelerated partial breast swelling (APBI) in early stages of breast cancer patients.

Anahtar Kelimeler:

Özet:

It is aimed to compare target volume and critical organ doses by using Volumetric Arc Therapy (VMAT) and CyberKnife techniques in accelerated partial breast irradiation in patients with early stage breast cancer. For this study, 10 patients diagnosed with early stage breast cancer who received radiotherapy were selected. VMAT and CyberKnife (SBRT) virtual plans were created with a daily fraction dose of 6 Gy and a total dose of 30 Gy. Homogeneity index (HI), conformity index (CI), treatment duration (s), gross tumor volume (GTV) and dose values received by critical organs were compared. A significant difference was found between the treatment plans in favor of the VMAT technique in the Dmax (p=0.002) value of GTV. It was observed that 30 Gy (V30) (p=0.013) and 15 Gy (V15) values (p=0.007) of the ipsilateral breast received less dose in CyberKnife technique. There was no significant difference in terms of Dmax (p=0.218) of the contralateral breast. No significant difference was found for Dmax (p=0.282) and volume of the heart receiving 1.5 Gy (V1.5) (p=0.548) in cases located in the right breast. There was no significant difference in heart Dmax (p=0.095) in cases located in the left breast; however, the value (p=0.008) of the heart receiving 1.5 Gy (V1.5) was found to be lower in the CyberKnife technique. The duration (s) of treatment (p<0.001) was found to be significantly less in the VMAT technique. As a result, in both treatment techniques, the target volume received the desired dose; however, it has been found that the CyberKnife technique is superior in risky patients in terms of reducing late cardiac side effects that may occur especially in the early stage. In the light of technological developments, CyberKnife technique can be evaluated in appropriate cases as a current treatment approach in Accelerated Partial Breast Irradiation (APBI) in patients with early stage breast cancer.