Comparative analysis of the absorbed dose in the heart and anterior descending branch of the left coronary artery (LAD) in patients with left-sided breast cancer who received radiotherapy using 3D-CRT, IMRT and VMAT techniques.

PURPOSE: The purpose of this study was to compare the absorbed dose distributions within the heart and lad in patients with left-sided breast cancer who underwent radiotherapy using 3D-CRT, IMRT and VMAT techniques. METHODS: The treatment plans of 11 patients with left-sided breast cancer were analyzed. All of the patients were irradiated in our facility with DIBH 3D-CRT. For all patients the plans in the IMRT (sliding window) and VMAT (Rapid Arc - Varian) techniques were prepared. Cumulative dose-volume histograms (DVH) were used to compare the dose distributions between the plans for each patient. Statistical analysis was carried out using the one-way ANOVA with repeated measurements and Tukey's post hoc test. RESULTS: The use of IMRT and VMAT techniques allowed for a better coverage of the PTV with 95% isodose and a more homogeneous dose distribution compared to the 3D-CRT technique. The use of dynamic technique (IMRT or VMAT) did not provide significant protection for OARs - only the dose absorbed in LAD was slightly lower. CONCLUSION: The use of 3D-CRT allows better protection of critical organs compared to other techniques, except for the dose in the lad artery which was the lowest in IMRT technique. exposure of large tissue volumes to so-called low radiation doses is undoubtedly a disadvantage of using dynamic techniques.

Fertility impairment in radiotherapy.

Infertility as a result of antineoplastic therapy is becoming a very important issue due to the growing incidence of neoplastic diseases. Routinely applied antineoplastic treatments and the illness itself lead to fertility disorders. Therapeutic methods used in antineoplastic treatment may cause fertility impairment or sterilization due to permanent damage to reproductive cells. The risk of sterilization depends on the patient's sex, age during therapy, type of neoplasm, radiation dose and treatment area. It is known that chemotherapy and radiotherapy can lead to fertility impairment and the combination of these two gives an additive effect. The aim of this article is to raise the issue of infertility in these patients. It is of growing importance due to the increase in the number of children and young adults who underwent radiotherapy in the past. The progress in antineoplastic therapy improves treatment results, but at the same time requires a deeper look at existential needs of the patient. Reproductive function is an integral element of self-esteem and should be taken into account during therapy planning.