Superiority of equivalent uniform dose (EUD)-based optimization for breast and chest wall

Medical Dosimetry : Official Journal of the American Association of Medical Dosimetrists
Dimitris N MihailidisPelagia Tomara

Abstract

We investigate whether IMRT optimization based on generalized equivalent uniform dose (gEUD) objectives for organs at risk (OAR) results in superior dosimetric outcomes when compared with multiple dose-volume (DV)-based objectives plans for patients with intact breast and postmastectomy chest wall (CW) cancer. Four separate IMRT plans were prepared for each of the breast and CW cases (10 patients). The first three plans used our standard in-house, physician-selected, DV objectives (phys-plan); gEUD-based objectives for the OARs (gEUD-plan); and multiple, "very stringent," DV objectives for each OAR and PTV (DV-plan), respectively. The fourth plan was only beam-fluence optimized (FO-plan), without segmentation, which used the same objectives as in the DV-plan. The latter plan was to be used as an "optimum" benchmark without the effects of the segmentation for deliverability. Dosimetric quantities, such as V(20Gy) for the ipsilateral lung and mean dose (D(mean)) for heart, contralateral breast, and contralateral lung were used to evaluate the results. For all patients in this study, we have seen that the gEUD-based plans allow greater sparing of the OARs while maintaining equivalent target coverage. The average ipsilateral lung V...Continue Reading

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Citations

Aug 6, 2011·Medical Physics·Clay HoldsworthMark H Phillips
Feb 14, 2014·International Journal of Radiation Oncology, Biology, Physics·Dimitris N Mihailidis
Oct 9, 2013·Medical Dosimetry : Official Journal of the American Association of Medical Dosimetrists·Shichao WangNianyong Chen
Nov 2, 2015·Medical Physics·Sarah C BrüningkJan J Wilkens
Apr 1, 2011·Practical Radiation Oncology·Hiral P FontanillaLei Dong
Sep 23, 2014·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Sarah QuirkWendy L Smith
Nov 21, 2017·Journal of Applied Clinical Medical Physics·Antonella FogliataLuca Cozzi
Dec 17, 2010·Medical Physics·Bo ZhaoJay Burmeister
Oct 11, 2019·Veterinary Radiology & Ultrasound : the Official Journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association·Valeria MeierCarla Rohrer Bley
Nov 30, 2019·Technology in Cancer Research & Treatment·Caiping GuoJinrong Xu

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