Synergistic Integration of VMAT and 3DCRT in Breast Cancer Radiotherapy: Enhancing Therapeutic Precision
Résumé
Breast cancer radiotherapy has undergone significant advancements, evolving beyond traditional three-dimensional conformal radiation therapy (3DCRT) to embrace innovative techniques such as field-in-field, intensity-modulated radiation therapy (IMRT), and more recently, volumetric modulated arc therapy (VMAT). These developments aim to optimize tumor targeting while safeguarding adjacent healthy tissues. Notably, VMAT offers substantial reductions in high-dose exposure to normal tissues but introduces a concomitant increase in low-dose exposure to previously unaffected areas. This study presents a novel hybrid approach that amalgamates the robustness of 3DCRT with the advanced precision of VMAT, aiming to balance the strengths of both methodologies. Through rigorous statistical analysis—including ANOVA, Wilcoxon tests, determination coefficients, and ROC analysis—we evaluate the efficacy of this hybrid technique in specific clinical scenarios, such as right breast cases, patients with a body mass index (BMI) over 23, age over 48, and target volumes exceeding 350 cc. Our findings suggest that hybridization, tailored to individual patient morphology and breast laterality, may emerge as a superior therapeutic strategy in breast cancer radiotherapy. This integrated approach has the potential to refine treatment protocols, enhancing clinical outcomes and reducing collateral damage to healthy tissues.
