Glandular tissue–based versus anatomical landmark–based CTV delineation in postoperative breast cancer radiotherapy: a dosimetric comparison - Report - MDSpire
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Glandular tissue–based versus anatomical landmark–based CTV delineation in postoperative breast cancer radiotherapy: a dosimetric comparison
Clinical Report: Comparison of Glandular Tissue and Anatomical Landmark Methods for CTV Delineation
Overview
This study compares two methods of clinical target volume (CTV) delineation in postoperative breast cancer radiotherapy: anatomical landmark-based and glandular tissue-based approaches. The glandular tissue-based method resulted in significantly smaller target volumes and reduced radiation exposure to organs at risk.
Background
Accurate delineation of CTV is crucial in postoperative breast cancer radiotherapy to ensure effective treatment while minimizing exposure to surrounding organs. The choice between anatomical landmark and glandular tissue-based approaches can significantly impact dosimetric outcomes. Understanding these differences is essential for optimizing treatment plans and improving patient safety.
Data Highlights
Parameter
CTVan
CTVgl
P-value
Volume (cc)
582.59 ± 232.55
432.87 ± 184.09
< 0.001
Left Lung V20
Higher
Lower
< 0.001
Mean Heart Dose
Higher
Lower
< 0.001
Heart V40
Higher
Lower
< 0.001
CB Dmean
Higher
Lower
< 0.001
Key Findings
CTVgl volumes were significantly smaller than CTVan volumes (432.87 cc vs. 582.59 cc; P < 0.001).
Glandular-based delineation resulted in lower Dmax and higher D98 values.
Radiation exposure to the left lung, heart, and contralateral breast was significantly reduced in the CTVgl group (P < 0.001).
CTV volume positively correlated with heart and contralateral breast doses.
Left lung dose showed weaker and more variable associations with CTV volume.
Clinical Implications
The findings suggest that using a glandular tissue-based approach for CTV delineation can enhance patient safety by minimizing radiation exposure to critical organs. Clinicians should consider adopting this method to improve dosimetric outcomes in postoperative breast cancer radiotherapy.
Conclusion
Glandular tissue-based delineation offers significant dosimetric advantages over anatomical landmark-based methods, highlighting the need for further studies to assess long-term clinical implications.
