Sequential or simultaneous-integrated boost in early-stage breast cancer patients: trade-offs between skin toxicity and risk of compromised coverage
Abstract Purpose To determine the dosimetric effects of set-up errors on boost coverage, and compares skin toxicity of sequential and simultaneous boost techniques for left-sided breast cancer. Materials and methods This retrospective study included 23 early-stage breast cancer cases. Single isocent...
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BMC
2025-01-01
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| Series: | Radiation Oncology |
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| Online Access: | https://doi.org/10.1186/s13014-025-02584-0 |
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| author | Changyou Zhong Minfeng Huang Haidong Yu Jun Yuan Ruilian Xie Zhenzhen Lai Shanzhou Niu Chunbo Tang |
| author_facet | Changyou Zhong Minfeng Huang Haidong Yu Jun Yuan Ruilian Xie Zhenzhen Lai Shanzhou Niu Chunbo Tang |
| author_sort | Changyou Zhong |
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| description | Abstract Purpose To determine the dosimetric effects of set-up errors on boost coverage, and compares skin toxicity of sequential and simultaneous boost techniques for left-sided breast cancer. Materials and methods This retrospective study included 23 early-stage breast cancer cases. Single isocenter HFWBI-SIB(s-SIB), single isocenter HFWBI-SB(s-SB) and dual isocenter HFWBI-SB(d-SB) were planing. Rotations of 0.5°, 1°, and 2° coupled with translationals of 0.5 mm, 1.0 mm, and 2.0 mm were applied along three orthogonal axes. The dose to 95% of the PTV (D95) and the volume covered by 95% of the prescribed dose (V95) were evaluated using GEE univariate analysis to determine how PTV coverage was related to 1/CIRTOG, PTVboost volume, PTVboost separation to isocenter. The relationship between the high-dose regions within the PTVbreast and Ratio_V was evaluated using univariate analysis. Results The s-SIB had optimal target coverage and lower high-dose volume, but it increased the risk of compromised coverage to tumor bed. For the s-SB technique, V95 exceeded 95% under all setup errors. At 2.0° coupled with 2.0 mm, s-SIB and d-SB exhibited V95 values below 95% in 34.8% and 8.7% of cases, respectively. At other setup errors, both s-SIB and d-SB demonstrated V95 values greater than 95%. Notably, high-dose regions such as V105%, V107%, and V110% within the PTVbreast across the three techniques displayed a significant correlation with Ratio_V. Conclusion Simultaneous-integrated boost for early-stage breast cancer can reduce skin toxicity compared to sequential techniques but with the risk of compromising tumor bed coverage. |
| format | Article |
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| institution | Kabale University |
| issn | 1748-717X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | Radiation Oncology |
| spelling | doaj-art-d939a7b74cf94d39a301808dd0a9d8dd2025-01-26T12:45:58ZengBMCRadiation Oncology1748-717X2025-01-0120111510.1186/s13014-025-02584-0Sequential or simultaneous-integrated boost in early-stage breast cancer patients: trade-offs between skin toxicity and risk of compromised coverageChangyou Zhong0Minfeng Huang1Haidong Yu2Jun Yuan3Ruilian Xie4Zhenzhen Lai5Shanzhou Niu6Chunbo Tang7Radiotherapy Department, Meizhou People’s Hospital, Huangtang HospitalDepartment of Oncology, First Affiliated Hospital of Gannan Medical UniversityRadiotherapy Department, Meizhou People’s Hospital, Huangtang HospitalDepartment of Oncology, First Affiliated Hospital of Gannan Medical UniversityDepartment of Oncology, First Affiliated Hospital of Gannan Medical UniversitySchool of Mathematics and Computer Science, Gannan Normal UniversitySchool of Mathematics and Computer Science, Gannan Normal UniversityDepartment of Oncology, First Affiliated Hospital of Gannan Medical UniversityAbstract Purpose To determine the dosimetric effects of set-up errors on boost coverage, and compares skin toxicity of sequential and simultaneous boost techniques for left-sided breast cancer. Materials and methods This retrospective study included 23 early-stage breast cancer cases. Single isocenter HFWBI-SIB(s-SIB), single isocenter HFWBI-SB(s-SB) and dual isocenter HFWBI-SB(d-SB) were planing. Rotations of 0.5°, 1°, and 2° coupled with translationals of 0.5 mm, 1.0 mm, and 2.0 mm were applied along three orthogonal axes. The dose to 95% of the PTV (D95) and the volume covered by 95% of the prescribed dose (V95) were evaluated using GEE univariate analysis to determine how PTV coverage was related to 1/CIRTOG, PTVboost volume, PTVboost separation to isocenter. The relationship between the high-dose regions within the PTVbreast and Ratio_V was evaluated using univariate analysis. Results The s-SIB had optimal target coverage and lower high-dose volume, but it increased the risk of compromised coverage to tumor bed. For the s-SB technique, V95 exceeded 95% under all setup errors. At 2.0° coupled with 2.0 mm, s-SIB and d-SB exhibited V95 values below 95% in 34.8% and 8.7% of cases, respectively. At other setup errors, both s-SIB and d-SB demonstrated V95 values greater than 95%. Notably, high-dose regions such as V105%, V107%, and V110% within the PTVbreast across the three techniques displayed a significant correlation with Ratio_V. Conclusion Simultaneous-integrated boost for early-stage breast cancer can reduce skin toxicity compared to sequential techniques but with the risk of compromising tumor bed coverage.https://doi.org/10.1186/s13014-025-02584-0SequentialSimultaneous-integratedSkin toxicityTumor bed coveragePredictive models |
| spellingShingle | Changyou Zhong Minfeng Huang Haidong Yu Jun Yuan Ruilian Xie Zhenzhen Lai Shanzhou Niu Chunbo Tang Sequential or simultaneous-integrated boost in early-stage breast cancer patients: trade-offs between skin toxicity and risk of compromised coverage Radiation Oncology Sequential Simultaneous-integrated Skin toxicity Tumor bed coverage Predictive models |
| title | Sequential or simultaneous-integrated boost in early-stage breast cancer patients: trade-offs between skin toxicity and risk of compromised coverage |
| title_full | Sequential or simultaneous-integrated boost in early-stage breast cancer patients: trade-offs between skin toxicity and risk of compromised coverage |
| title_fullStr | Sequential or simultaneous-integrated boost in early-stage breast cancer patients: trade-offs between skin toxicity and risk of compromised coverage |
| title_full_unstemmed | Sequential or simultaneous-integrated boost in early-stage breast cancer patients: trade-offs between skin toxicity and risk of compromised coverage |
| title_short | Sequential or simultaneous-integrated boost in early-stage breast cancer patients: trade-offs between skin toxicity and risk of compromised coverage |
| title_sort | sequential or simultaneous integrated boost in early stage breast cancer patients trade offs between skin toxicity and risk of compromised coverage |
| topic | Sequential Simultaneous-integrated Skin toxicity Tumor bed coverage Predictive models |
| url | https://doi.org/10.1186/s13014-025-02584-0 |
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