Template-based breast IMRT planning for increased workload efficiency

Background: To be less resource intensive, we developed a template-based breast IMRT technique (TB-IMRT). This study aims to compare resources and dose distribution between TB-IMRT and conventional breast radiation (CBR). Methods: Twenty patients with early stage breast cancer were planned using CBR and TB-IMRT. Time to plan, coverage of volumes, dose to critical structures and treatment times were evaluated for CBR and TB-IMRT. Two sided-paired t tests were used. Results: TB-IMRT planning time was less than CBR (14.0 vs 39.0 min, p < 0.001). Fifteen patients with CBR needed 18 MV, and 11 of these were planned successfully with TB-IMRT using 6 MV. TB-IMRT provided better homogeneity index (0.096 vs 0.124, p < 0.001) and conformity index (0.68 vs 0.59, p = 0.003). Dose to critical structures were comparable between TB-IMRT and CBR, and treatment times were also similar (6.0 vs 7.8 min, p = 0.13). Conclusions: TB-IMRT provides reduction of planning time and minimizes the use of high energy beams, while providing similar treatment times and equal plans compared to CBR. This technique permits efficient use of resources with a low learning curve, and can be done with existing equipment and personnel.