Effect of jaw width in jaw tracking mode on the radiotherapy dose of partial arc VMAT in patients undergoing left breast-conserving surgery

Abstract To analyze the effect of jaw width in jaw tracking mode on the dose of radiotherapy partial arc VMAT (P-VMAT) for patients undergoing left breast-conserving surgery and to explore the best jaw width as the initial inverse optimization parameter. Twenty patients who underwent left breast-con...

Full description

Saved in:
Bibliographic Details
Main Authors: Hai-liang Guo, Yan Huan, Jing-hua Zhong, Hao-wen Pang, Huai-wen Zhang
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
Subjects:
Online Access:https://doi.org/10.1038/s41598-025-01267-w
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850190990943453184
author Hai-liang Guo
Yan Huan
Jing-hua Zhong
Hao-wen Pang
Huai-wen Zhang
author_facet Hai-liang Guo
Yan Huan
Jing-hua Zhong
Hao-wen Pang
Huai-wen Zhang
author_sort Hai-liang Guo
collection DOAJ
description Abstract To analyze the effect of jaw width in jaw tracking mode on the dose of radiotherapy partial arc VMAT (P-VMAT) for patients undergoing left breast-conserving surgery and to explore the best jaw width as the initial inverse optimization parameter. Twenty patients who underwent left breast-conserving surgery were randomly selected. Six groups of P-VMAT plans were designed (named Plan0, Plan0.3, Plan0.6, Plan0.9, Plan-0.3, and Plan-0.6). The width of the jaw of each plan was changed in 0.3 cm steps along the X direction (from − 0.6 to 0.9 cm) according to the beginning of the half beam (Plan0). The PTV coverage, conformity index (CI), homogeneity index (HI), monitor units (MU) and organs at risk (OARs) dose were evaluated by repeated measurement data analysis of variance between plan0 and the other plans. Additionally, the correlations between CI, HI, MU and OARs to change in jaw width were analyzed using Spearman’s bivariate correlation analysis. The PTV dose distributions of Plan-0.3 and Plan-0.6, which have smaller jaw widths than those of Plan0, did not meet the clinical requirements. CI, HI and MU were correlated with jaw width (r = 0.554, -0.501, -0.641, p < 0.05, respectively). The V5, V10, V20, V40, Dmean and Dmax of the heart were correlated with jaw width (r = 0.288, 0.284, 0.191, -0.27, 0.186, -0.245, p < 0.05, respectively). The V2.5, V5, V10, V20, V40 and Dmean of the left lung (Lung-L) were correlated with jaw width (0.298, 0.421, 0.516, 0.391, -0.241, 0.356, p < 0.05, respectively). Among all the plans to ensure PTV target coverage, Plan0 had the lowest clinical indicators for the heart and Lung-L (p < 0.05, respectively). The internal boundary of the jaw set as 0 cm (Plan0) represents the optimal jaw width for the initial optimization of the plan design. This method is the simplest and most effective for radiotherapy treatment planning for breast-conserving surgery for breast cancer as well as allows ideal dose distribution.
format Article
id doaj-art-db853d3f332b483080a71964c5408c3f
institution OA Journals
issn 2045-2322
language English
publishDate 2025-05-01
publisher Nature Portfolio
record_format Article
series Scientific Reports
spelling doaj-art-db853d3f332b483080a71964c5408c3f2025-08-20T02:15:02ZengNature PortfolioScientific Reports2045-23222025-05-0115111210.1038/s41598-025-01267-wEffect of jaw width in jaw tracking mode on the radiotherapy dose of partial arc VMAT in patients undergoing left breast-conserving surgeryHai-liang Guo0Yan Huan1Jing-hua Zhong2Hao-wen Pang3Huai-wen Zhang4Department of Oncology, Jiangxi Clinical Research Center for Cancer, the First Affiliated Hospital of Gannan Medical University, First Clinical Medical College, Gannan Medical UniversityDepartment of Oncology, People’s Hospital of Qianxinan Buyi and Miao Minority Autonomous PrefectureDepartment of Oncology, Jiangxi Clinical Research Center for Cancer, the First Affiliated Hospital of Gannan Medical University, First Clinical Medical College, Gannan Medical UniversityDepartment of Oncology, The Affiliated Hospital of Southwest Medical UniversityDepartment of Radiotherapy, Jiangxi Clinical Research Center for Cancer, Jiangxi Cancer Hospital & Institute, The Second Affiliated Hospital of Nanchang Medical CollegeAbstract To analyze the effect of jaw width in jaw tracking mode on the dose of radiotherapy partial arc VMAT (P-VMAT) for patients undergoing left breast-conserving surgery and to explore the best jaw width as the initial inverse optimization parameter. Twenty patients who underwent left breast-conserving surgery were randomly selected. Six groups of P-VMAT plans were designed (named Plan0, Plan0.3, Plan0.6, Plan0.9, Plan-0.3, and Plan-0.6). The width of the jaw of each plan was changed in 0.3 cm steps along the X direction (from − 0.6 to 0.9 cm) according to the beginning of the half beam (Plan0). The PTV coverage, conformity index (CI), homogeneity index (HI), monitor units (MU) and organs at risk (OARs) dose were evaluated by repeated measurement data analysis of variance between plan0 and the other plans. Additionally, the correlations between CI, HI, MU and OARs to change in jaw width were analyzed using Spearman’s bivariate correlation analysis. The PTV dose distributions of Plan-0.3 and Plan-0.6, which have smaller jaw widths than those of Plan0, did not meet the clinical requirements. CI, HI and MU were correlated with jaw width (r = 0.554, -0.501, -0.641, p < 0.05, respectively). The V5, V10, V20, V40, Dmean and Dmax of the heart were correlated with jaw width (r = 0.288, 0.284, 0.191, -0.27, 0.186, -0.245, p < 0.05, respectively). The V2.5, V5, V10, V20, V40 and Dmean of the left lung (Lung-L) were correlated with jaw width (0.298, 0.421, 0.516, 0.391, -0.241, 0.356, p < 0.05, respectively). Among all the plans to ensure PTV target coverage, Plan0 had the lowest clinical indicators for the heart and Lung-L (p < 0.05, respectively). The internal boundary of the jaw set as 0 cm (Plan0) represents the optimal jaw width for the initial optimization of the plan design. This method is the simplest and most effective for radiotherapy treatment planning for breast-conserving surgery for breast cancer as well as allows ideal dose distribution.https://doi.org/10.1038/s41598-025-01267-wLeft breast-conserving surgeryPartial arc VMATJaw widthOrgan at riskDosimetry
spellingShingle Hai-liang Guo
Yan Huan
Jing-hua Zhong
Hao-wen Pang
Huai-wen Zhang
Effect of jaw width in jaw tracking mode on the radiotherapy dose of partial arc VMAT in patients undergoing left breast-conserving surgery
Scientific Reports
Left breast-conserving surgery
Partial arc VMAT
Jaw width
Organ at risk
Dosimetry
title Effect of jaw width in jaw tracking mode on the radiotherapy dose of partial arc VMAT in patients undergoing left breast-conserving surgery
title_full Effect of jaw width in jaw tracking mode on the radiotherapy dose of partial arc VMAT in patients undergoing left breast-conserving surgery
title_fullStr Effect of jaw width in jaw tracking mode on the radiotherapy dose of partial arc VMAT in patients undergoing left breast-conserving surgery
title_full_unstemmed Effect of jaw width in jaw tracking mode on the radiotherapy dose of partial arc VMAT in patients undergoing left breast-conserving surgery
title_short Effect of jaw width in jaw tracking mode on the radiotherapy dose of partial arc VMAT in patients undergoing left breast-conserving surgery
title_sort effect of jaw width in jaw tracking mode on the radiotherapy dose of partial arc vmat in patients undergoing left breast conserving surgery
topic Left breast-conserving surgery
Partial arc VMAT
Jaw width
Organ at risk
Dosimetry
url https://doi.org/10.1038/s41598-025-01267-w
work_keys_str_mv AT hailiangguo effectofjawwidthinjawtrackingmodeontheradiotherapydoseofpartialarcvmatinpatientsundergoingleftbreastconservingsurgery
AT yanhuan effectofjawwidthinjawtrackingmodeontheradiotherapydoseofpartialarcvmatinpatientsundergoingleftbreastconservingsurgery
AT jinghuazhong effectofjawwidthinjawtrackingmodeontheradiotherapydoseofpartialarcvmatinpatientsundergoingleftbreastconservingsurgery
AT haowenpang effectofjawwidthinjawtrackingmodeontheradiotherapydoseofpartialarcvmatinpatientsundergoingleftbreastconservingsurgery
AT huaiwenzhang effectofjawwidthinjawtrackingmodeontheradiotherapydoseofpartialarcvmatinpatientsundergoingleftbreastconservingsurgery