Optimum Treatment Planning Technique Evaluation For Synchronous Bilateral Breast Cancer With Left Side Supraclavicular Lymph Nodes

Background: the Bilateral breast cancer cases are classified as a complex in radiotherapy treatment especially those with the left side mastectomy and right-side lumpectomy with left side supraclavicular lymph nodes patients. The purpose of this study is to find the optimum treatment planning technique among the three available techniques: 3D-CRT, IMRT, and VMAT.Materials and Methods: Ten Bilateral breast cancer included in this study with left side mastectomy and right-side lumpectomy with left side supraclavicular lymph nodes. The cross-sectional clinical study conducted in Baghdad ‎radiotherapy and nuclear medicine and Al-Andalus privet radiotherapy ‎hospital, Baghdad, Iraq. The patients are delineated by oncologists and prepare for radiation planning by MONACO 5.1 treatment planning system (TPS) with an X-ray photon beam of 6 MV or 10 MV energy using ‎ELEKTA‏’‏s Agility linear accelerator. The prescribed dose set at (4005 cCy per 15 fractions. Results: The treatment with 3D-CRT, IMRT, and VMAT show a significant difference in the results. VMAT give high dose distribution for the left mastectomy breast and it’s regional supraclavicular lymph nodes while the IMRT gives a higher value for the right side breast with lumpectomy. The good homogeneity index acquired with IMRT while VMAT gives a better conformity index. The 3D-CRT planning technique lowers the dose tho the heart and lunges better than the other techniques.Conclusion: Depending on the patient health and stage, the optimum treatment planning applied. Generally, VMAT is the optimum treatment planning technique for the studied group of SBBC patients. IMRT give effective coverage results better than the 3D-CRT.