The efficacy of multi-leaf collimator in the reduction of cardiac and coronary artery dose in left-sided breast cancer radiotherapy

Abstract

Background: Multi-leaf collimator (MLC) is one of the efficient and cost-effective methods for protecting sensitive tissues around the target. This study aimed to evaluate the protective effect of MLC on the protection of sensitive organs in patients with left breast cancer. Materials and Methods: This study was performed on computed tomography (CT) scans of 45 patients with left breast cancer. Two treatment plans were completed for each patient. Only the heart and left lung were considered organs at risk in the first treatment plan, and in the second treatment plan, the left anterior descending artery (LAD) was also considered the organ at risk. It was covered as much as possible by the MLC. Dosimetric results of tumor and organ at risk (OARs) were extracted from the dose-volume histogram and compared. Results: The results showed that more LAD coverage by MLC leads to a significant reduction in the mean dose of OARs (P-value <0.05). The mean dose for heart, LAD, and left lung decreased by 11%, 7.4%, and 4.9%, respectively. The values of V5 (volume received the dose of 5 Gy) and V20 for the lung, V10, V25, and V30 for LAD, and V5, V20, V25, and V30 for the heart also decreased significantly (P-value <0.05). Conclusions: In general, better protection of LAD, heart, and lungs can be achieved by maximal shielding organs at risk by MLC in radiation therapy for patients with left breast cancer.

Keywords

• breast neoplasms
• cardiotoxicity
• conformal
• radiotherapy