TURKISH JOURNAL OF ONCOLOGY 2018 , Vol 33 , Num 1
Evaluation of Effect of Inverse and Field-in-Field IMRT Planning for Left-Sided Anterior Descending Coronary Artery Doses in Left-Sided Breast Cancer Patients
Esil KARA1,Müge AKMANSU2,Bahar DİRİCAN3,Aslı YAZICI1
1Department of Radiation Oncology, ONKO Ankara Oncology Center, Ankara-Turkey
2Department of Radiation Oncology, Gazi University, Ankara-Turkey
3Department of Radiation Oncology, Gülhane Training and Research Hospital, Ankara-Turkey
DOI : 10.5505/tjo.2017.1688 OBJECTIVE The aim of the study is to evaluate radiation doses of left-sided whole-breast irradiation on left-sided anterior descending coronary artery (LAD) among various radiotherapy treatment planning techniques for 45 left-sided breast cancer patients.

METHODS
Three different radiotherapy techniques, field-in-field, 4-field inverse IMRT, and 5-field IMRT, were undertaken. For inverse IMRT, the fields were special for each patient. We used 2 opposed tangential beams in the field-in-field technique, and for the other two techniques, the beams were obtained by 10° refraction.

RESULTS
The 5-field IMRT technique is not useful for decreasing the LADmax dose. We figured out that in the field-in-field technique, 18 of our 45 patients received doses greater than 10 Gy to LAD. We also found that using the 4-field inverse IMRT technique, LAD and lung doses could be reduced.

CONCLUSION
The mean LADmax dose was smaller than 10 Gy for all techniques except the field-in-field technique. There was no significant difference between 4-field inverse IMRT and field-in-field techniques. However, if LAD is located deeper than 2.5 cm, the LADmax dose could increase; this could further be decreased to under 10 Gy using the 4-field inverse IMRT technique. Keywords : IMRT; left Breast Cancer; LAD; radiotherapy