Dosimetric study of TrueBeam single-isocenter vs. Halcyon dual-isocenter VMAT radiotherapy plans for postoperative left-sided breast cancer

Abstract Background This study compared the plan quality and execution efficiency of VMAT plans using TrueBeam single-isocenter and Halcyon dual-isocenter systems for postoperative left-sided breast cancer, providing evidence for the selection and application of radiotherapy methods after breast can...

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Main Authors: Chaojun Chai, Kainan Shao, Guoping Shan, Pu Li, Fenglei Du, Yiwei Yang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-14574-2
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author Chaojun Chai
Kainan Shao
Guoping Shan
Pu Li
Fenglei Du
Yiwei Yang
author_facet Chaojun Chai
Kainan Shao
Guoping Shan
Pu Li
Fenglei Du
Yiwei Yang
author_sort Chaojun Chai
collection DOAJ
description Abstract Background This study compared the plan quality and execution efficiency of VMAT plans using TrueBeam single-isocenter and Halcyon dual-isocenter systems for postoperative left-sided breast cancer, providing evidence for the selection and application of radiotherapy methods after breast cancer surgery. Methods Twenty postoperative left-sided breast cancer patients treated at Zhejiang Cancer Hospital from January 2020 to August 2022 were included in the study. Using the RayStation 9 A system, TrueBeam single-isocenter (T group) and Halcyon dual-isocenter (H group) VMAT plans were created. The study compared PTV (Planning Target Volume) conformity index (CI), homogeneity index (HI), mean and maximum doses, dose to organs at risk (OAR), monitor units (MU), beam-on time, and plan complexity between the groups. Results Both groups’ plans met clinical objectives with good dose distribution and target coverage. Significant statistical differences were observed in the PTV maximum dose (Dmax), mean dose (Dmean), and D50 between the two groups (P < 0.05), with the H group outperforming the T group. There was no statistically significant difference in CI and HI between the two groups (P > 0.05). The OAR doses were lower in the H group compared to the T group, with significant statistical differences observed in heart Dmean, left lung (Dmean, V5, V20, V30), lungs (Dmean, V5, V20, V30), and humeral head Dmax (P < 0.05), and there was no statistically significant difference in heart (V30, V40), spinal cord Dmax, and right breast Dmean (P < 0.05). In terms of plan quality assessment, the total MU for the H group was significantly higher (1066.704 ± 135.183) than that for the T group (772.992 ± 104.023), with extremely significant statistical differences (P < 0.01). The beam-on time for the H group was significantly longer (101.328 ± 9.359 s) than that for the T group (53.535 ± 12.655 s), with extremely significant statistical differences (P < 0.01). The plan complexity for the H group was significantly higher (0.101 ± 0.009 cm−1) than that for the T group (0.068 ± 0.009 cm−1), with extremely significant statistical differences (P < 0.01). Conclusions The study found that Halcyon dual-isocenter VMAT plans offered better PTV uniformity and coverage while protecting OARs more effectively. Despite higher MU, beam-on time, and plan complexity, the H group’s dosimetric advantages and reduced manual positioning errors make it a safe and effective treatment option for postoperative breast cancer.
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spelling doaj-art-db9c290fe9714c759d048c02d0d5d9162025-08-20T03:43:11ZengBMCBMC Cancer1471-24072025-07-012511910.1186/s12885-025-14574-2Dosimetric study of TrueBeam single-isocenter vs. Halcyon dual-isocenter VMAT radiotherapy plans for postoperative left-sided breast cancerChaojun Chai0Kainan Shao1Guoping Shan2Pu Li3Fenglei Du4Yiwei Yang5Department of Radiation Physics, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Radiation Oncology, Zhejiang Provincial People’s HospitalDepartment of Radiation Physics, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Radiation Physics, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Radiation Physics, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Radiation Physics, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesAbstract Background This study compared the plan quality and execution efficiency of VMAT plans using TrueBeam single-isocenter and Halcyon dual-isocenter systems for postoperative left-sided breast cancer, providing evidence for the selection and application of radiotherapy methods after breast cancer surgery. Methods Twenty postoperative left-sided breast cancer patients treated at Zhejiang Cancer Hospital from January 2020 to August 2022 were included in the study. Using the RayStation 9 A system, TrueBeam single-isocenter (T group) and Halcyon dual-isocenter (H group) VMAT plans were created. The study compared PTV (Planning Target Volume) conformity index (CI), homogeneity index (HI), mean and maximum doses, dose to organs at risk (OAR), monitor units (MU), beam-on time, and plan complexity between the groups. Results Both groups’ plans met clinical objectives with good dose distribution and target coverage. Significant statistical differences were observed in the PTV maximum dose (Dmax), mean dose (Dmean), and D50 between the two groups (P < 0.05), with the H group outperforming the T group. There was no statistically significant difference in CI and HI between the two groups (P > 0.05). The OAR doses were lower in the H group compared to the T group, with significant statistical differences observed in heart Dmean, left lung (Dmean, V5, V20, V30), lungs (Dmean, V5, V20, V30), and humeral head Dmax (P < 0.05), and there was no statistically significant difference in heart (V30, V40), spinal cord Dmax, and right breast Dmean (P < 0.05). In terms of plan quality assessment, the total MU for the H group was significantly higher (1066.704 ± 135.183) than that for the T group (772.992 ± 104.023), with extremely significant statistical differences (P < 0.01). The beam-on time for the H group was significantly longer (101.328 ± 9.359 s) than that for the T group (53.535 ± 12.655 s), with extremely significant statistical differences (P < 0.01). The plan complexity for the H group was significantly higher (0.101 ± 0.009 cm−1) than that for the T group (0.068 ± 0.009 cm−1), with extremely significant statistical differences (P < 0.01). Conclusions The study found that Halcyon dual-isocenter VMAT plans offered better PTV uniformity and coverage while protecting OARs more effectively. Despite higher MU, beam-on time, and plan complexity, the H group’s dosimetric advantages and reduced manual positioning errors make it a safe and effective treatment option for postoperative breast cancer.https://doi.org/10.1186/s12885-025-14574-2Breast cancerVolumetric moderated arc therapyDual-isocenterDosimetryPlan quality
spellingShingle Chaojun Chai
Kainan Shao
Guoping Shan
Pu Li
Fenglei Du
Yiwei Yang
Dosimetric study of TrueBeam single-isocenter vs. Halcyon dual-isocenter VMAT radiotherapy plans for postoperative left-sided breast cancer
BMC Cancer
Breast cancer
Volumetric moderated arc therapy
Dual-isocenter
Dosimetry
Plan quality
title Dosimetric study of TrueBeam single-isocenter vs. Halcyon dual-isocenter VMAT radiotherapy plans for postoperative left-sided breast cancer
title_full Dosimetric study of TrueBeam single-isocenter vs. Halcyon dual-isocenter VMAT radiotherapy plans for postoperative left-sided breast cancer
title_fullStr Dosimetric study of TrueBeam single-isocenter vs. Halcyon dual-isocenter VMAT radiotherapy plans for postoperative left-sided breast cancer
title_full_unstemmed Dosimetric study of TrueBeam single-isocenter vs. Halcyon dual-isocenter VMAT radiotherapy plans for postoperative left-sided breast cancer
title_short Dosimetric study of TrueBeam single-isocenter vs. Halcyon dual-isocenter VMAT radiotherapy plans for postoperative left-sided breast cancer
title_sort dosimetric study of truebeam single isocenter vs halcyon dual isocenter vmat radiotherapy plans for postoperative left sided breast cancer
topic Breast cancer
Volumetric moderated arc therapy
Dual-isocenter
Dosimetry
Plan quality
url https://doi.org/10.1186/s12885-025-14574-2
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