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Background <p>Whole breast irradiation remains the standard in breast-conserving therapy for early-stage carcinoma. Conventional RapidArc™ plans, while dosimetrically efficient, are limited by fixed collimator position. This often leads to unnecessary irradiation to adjacent organs at risk (OARs)—particularly the contralateral breast, ipsilateral lung, and cardiac structures—resulting in increased low-dose exposure. These challenges are exacerbated in Chinese female patients due to characteristic anatomical features, such as smaller, crescent-shaped breasts, and closer heart-to-target distances. The novel RapidArc Dynamic™ system provides dynamic collimator rotation and static angle ports, enabling more beam shaping during volumetric modulated arc therapy. This study evaluates the implementation of RapidArc Dynamic™ for whole breast irradiation, comparing its dosimetric performance against conventional RapidArc™ in Chinese female patients.</p> Methods <p>Ten patients with early-stage left breast cancer were retrospectively replanned using RapidArc™ and RapidArc Dynamic™ on Eclipse™ (v18.1). All plans employed 6-MV photons on a TrueBeam™ linear accelerator equipped with a Millennium 120-leaf MLC, prescribed to deliver 40&#xa0;Gy in 15 fractions to breast planning target volume for evaluation. Dosimetric parameters for PTV and OARs were analyzed using Wilcoxon signed-rank test.</p> Results <p>The results demonstrated that RapidArc Dynamic™ reduced contralateral breast exposure by 5.7% in maximum dose (29.6&#xa0;Gy vs. 27.9&#xa0;Gy) and 27.5% in mean dose (4.0&#xa0;Gy vs. 2.9&#xa0;Gy). Significant doses reductions in lungs were observed with a 13% lower mean lung dose (4.6&#xa0;Gy vs. 4.0&#xa0;Gy). Cardiac sparing improved with 21.6% lower mean heart dose (3.7&#xa0;Gy vs. 2.9&#xa0;Gy).</p> Conclusions <p>RapidArc Dynamic™ demonstrates significant improvement in OARs sparing, despite anatomical challenges in Chinese female patients.</p> Clinical trial number <p>Not applicable.</p>

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Integrating static angle ports and dynamic collimator rotation in volumetric modulated arc therapy for hypofractionated whole breast irradiation in Chinese females: a single-centre dosimetric study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月16日

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  • Adams Hei Long Yuen,
  • Matthew Shing Cheung Yik,
  • Kenneth Tsz Hei Chung,
  • Fuk Hay Tang,
  • Christopher Wai Keung Lai,
  • Yue Li,
  • Yaqing Nong,
  • Mingmei Tang,
  • Zhen Zhang,
  • Xingliu Wang,
  • Xiaoshen Wang,
  • Weihua Zhu,
  • Fuqiang Chen,
  • Alex Hoi Ning Leung,
  • Jacky Tsz Lung Wong

摘要

Background

Whole breast irradiation remains the standard in breast-conserving therapy for early-stage carcinoma. Conventional RapidArc™ plans, while dosimetrically efficient, are limited by fixed collimator position. This often leads to unnecessary irradiation to adjacent organs at risk (OARs)—particularly the contralateral breast, ipsilateral lung, and cardiac structures—resulting in increased low-dose exposure. These challenges are exacerbated in Chinese female patients due to characteristic anatomical features, such as smaller, crescent-shaped breasts, and closer heart-to-target distances. The novel RapidArc Dynamic™ system provides dynamic collimator rotation and static angle ports, enabling more beam shaping during volumetric modulated arc therapy. This study evaluates the implementation of RapidArc Dynamic™ for whole breast irradiation, comparing its dosimetric performance against conventional RapidArc™ in Chinese female patients.

Methods

Ten patients with early-stage left breast cancer were retrospectively replanned using RapidArc™ and RapidArc Dynamic™ on Eclipse™ (v18.1). All plans employed 6-MV photons on a TrueBeam™ linear accelerator equipped with a Millennium 120-leaf MLC, prescribed to deliver 40 Gy in 15 fractions to breast planning target volume for evaluation. Dosimetric parameters for PTV and OARs were analyzed using Wilcoxon signed-rank test.

Results

The results demonstrated that RapidArc Dynamic™ reduced contralateral breast exposure by 5.7% in maximum dose (29.6 Gy vs. 27.9 Gy) and 27.5% in mean dose (4.0 Gy vs. 2.9 Gy). Significant doses reductions in lungs were observed with a 13% lower mean lung dose (4.6 Gy vs. 4.0 Gy). Cardiac sparing improved with 21.6% lower mean heart dose (3.7 Gy vs. 2.9 Gy).

Conclusions

RapidArc Dynamic™ demonstrates significant improvement in OARs sparing, despite anatomical challenges in Chinese female patients.

Clinical trial number

Not applicable.