The influence of the use of CT-planning on the irradiated boost volume in breast conserving treatment.

Background And Purpose: The purpose of this study was to investigate the effect of CT-based delineation and planning on the irradiated boost volume. For this specific purpose we used the data as derived from 2 prospective phase III randomised trials.

Patients And Methods: Data from 1331 patients (
Results: Median V(95%) in the conventional simulation-based treatment plans was 99 cc (range 9-628) for photons and was 98 cc (13-651) for electrons, whereas in the CT-planned patients, these figures were 178 cc (37-2699) and 150 cc (43-1272), respectively. Multivariable analysis showed an association of the irradiated boost volume with tumour size (p<0.0067), lumpectomy size (p<0.0002), and boost technique (p<0.0004). The use of a CT-scan for volume delineation and treatment planning remained significant (p<0.0001).

Conclusions: The use of a CT-scan for delineation and treatment planning led to a significant increase of the irradiated boost volume by a factor of 1.5-1.8, compared to conventional simulator-based plans.