The purpose of the in silico study was to compare free breathing volumetric modulated arc therapy (VMAT) to standard deep inspiration breath‐hold (DIBH) three‐dimensional conformal radiotherapy (3DCRT) and determine whether the former is a viable option for elderly patients with left‐sided early stage breast cancer. Data from 22 patients with early‐stage left breast carcinoma requiring breast‐only radiation therapy were used for this planning study. The robustness of VMAT plans when using the free breathing method was compared to that of standard 3DCRT plans using the DIBH method. The endpoints for evaluation were the target dose coverage as well as doses to the organs‐at‐risk. The free breathing VMAT plans produced a significantly higher mean dose to the heart and right breast than the DIBH‐3DCRT plans. Free breathing VMAT plans resulted in significantly better target coverage than did 3DCRT using DIBH. The external volume that received more than 40 Gy was significantly smaller in the VMAT plans. Free breathing VMAT is a viable alternative to DIBH 3DCRT in elderly patients with a limited life expectancy and in subjects who are unable to perform DIBH. The choice of treatment should be individualized, and all relevant risks ought to be considered.

中文翻译：

---

自由呼吸VMAT与深度吸气屏气3D适形放射疗法治疗早期左侧乳腺癌

电子计算机的目的这项研究的目的是将自由呼吸容积调制弧光疗法（VMAT）与标准深吸气屏息（DIBH）三维适形放疗（3DCRT）进行比较，并确定前者对于左侧早期乳房的老年患者是否可行癌症。该计划研究使用了22例仅接受乳房放疗的早期左乳腺癌患者的数据。使用自由呼吸法的VMAT计划的鲁棒性与使用DIBH方法的标准3DCRT计划的鲁棒性进行了比较。评估的终点是目标剂量范围以及处于危险中的器官剂量。与DIBH-3DCRT计划相比，自由呼吸VMAT计划对心脏和右乳房产生的平均剂量明显更高。与使用DIBH的3DCRT相比，自由呼吸VMAT计划产生的目标覆盖率明显更好。在VMAT计划中，接受超过40 Gy的外部体积要小得多。对于预期寿命有限的老年患者和无法进行DIBH的受试者，自由呼吸VMAT是DIBH 3DCRT的可行替代方案。治疗的选择应个体化，并应考虑所有相关风险。