Optimum Treatment Planning Technique Evaluation for Synchronous Bilateral Breast Cancer with Left Side Supraclavicular Lymph Nodes

Bilateral breast cancer cases are classified as complex in radiotherapy treatment, especially those with the left side mastectomy and right-side lumpectomy with left side supraclavicular lymph nodes patients. The purpose of this study is to find the optimum treatment planning technique among the three available techniques: 3Dimentional conformal Radiotherapy (3D-CRT), Intensity modulated radiation therapy (IMRT), and Volumetric Modulated Arc Therapu (VMAT).
Ten Bilateral breast cancer included in this study with left-side mastectomy and right-side lumpectomy with left-side supraclavicular lymph nodes. The patients are delineated by oncologists and prepared for radiation planning by MONACO 5.1 treatment planning system (TPS) with an X-ray photon beam of 6 MV or 10 MV energy using ‎ELEKTA‏’‏s Agility linear accelerator. The prescribed dose is set at 4005 cCy per 15 fractions. Statistically with anova test among each other.
The treatment with 3D-CRT, IMRT, and VMAT show a significant difference in the results. VMAT gives high dose distribution for the left mastectomy breast and its regional supraclavicular lymph nodes, while the IMRT gives a higher value for the right side breast with lumpectomy. The good homogeneity index is acquired with IMRT, while VMAT gives a better conformity index. The 3D-CRT planning technique lowers the dose to the heart and lunges better than the other techniques.
depending on the patient health and stage, the optimum treatment planning is applied. VMAT and IMRT give effective results than the 3D-CRT.