{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T03:12:51Z","timestamp":1776741171742,"version":"3.51.2"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T00:00:00Z","timestamp":1620259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Medical Radiation Sci"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Until late 2018, standard of practice at the Northern Sydney Cancer Centre (NSCC) for breast and nodal treatment was a conformal mono\u2010isocentric technique. A planning study comparing an existing mono\u2010isocentric three\u2010dimensional conformal radiotherapy (3D\u2010CRT) planning technique to a hybrid intensity\u2010modulated radiotherapy (hIMRT) approach for the whole breast and supraclavicular fossa (SCF) region was undertaken with the aim to improve plan quality by improving dose conformity\/homogeneity across target volumes and reducing hotspots outside the target.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cohort of 17 patients was retrospectively planned using the proposed hIMRT technique, keeping the same planning constraints as the original treated breast and SCF 3D\u2010CRT plan and normalising the 3D\u2010CRT plans to achieve minimum breast\/SCF target coverage to compare organs at risk (OARs). Normal tissue index (NTI) and homogeneity index (HI) were compared for plan quality as well as for evaluating OARs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The hIMRT technique showed statistically significant improvements in NTI and HI, as well as improvement in maximum brachial plexus and thyroid doses. There was a negligible increase in maximum oesophagus dose which could be improved if used in optimisation. Other OAR doses in the irradiated region were comparable to the 3D\u2010CRT plans, however maximum doses were reduced overall.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The hIMRT planning technique maintained clinically acceptable doses to OARs and reduced normal tissue dose while maintaining equivalent dose coverage to breast and SCF planning target volumes with improved conformity and homogeneity. The reduction in maximum doses promotes a favourable toxicity profile, with potential benefit of improved long\u2010term cosmesis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmrs.473","type":"journal-article","created":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T23:31:45Z","timestamp":1620343905000},"page":"75-84","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Potential gains: Comparison of a mono\u2010isocentric three\u2010dimensional conformal radiotherapy (3D\u2010CRT) planning technique to hybrid intensity\u2010modulated radiotherapy (hIMRT) to the whole breast and supraclavicular fossa (SCF) region"],"prefix":"10.1002","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2565-4807","authenticated-orcid":false,"given":"Leigh","family":"Ambrose","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Northern Sydney Cancer Centre Royal North Shore Hospital  St Leonards NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5308-0935","authenticated-orcid":false,"given":"Cameron","family":"Stanton","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Northern Sydney Cancer Centre Royal North Shore Hospital  St Leonards NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorraine","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Northern Sydney Cancer Centre Royal North Shore Hospital  St Leonards NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9290-0193","authenticated-orcid":false,"given":"Gillian","family":"Lamoury","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Northern Sydney Cancer Centre Royal North Shore Hospital  St Leonards NSW Australia"},{"name":"Northern Clinical School University of Sydney  Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4667-0870","authenticated-orcid":false,"given":"Marita","family":"Morgia","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Northern Sydney Cancer Centre Royal North Shore Hospital  St Leonards NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4959-0315","authenticated-orcid":false,"given":"Susan","family":"Carroll","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Northern Sydney Cancer Centre Royal North Shore Hospital  St Leonards NSW Australia"},{"name":"Northern Clinical School University of Sydney  Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8614-3496","authenticated-orcid":false,"given":"Regina","family":"Bromley","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Northern Sydney Cancer Centre Royal North Shore Hospital  St Leonards NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4350-0294","authenticated-orcid":false,"given":"John","family":"Atyeo","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Northern Sydney Cancer Centre Royal North Shore Hospital  St Leonards NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,5,6]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Australian Institute of Health and Welfare (AIHW).Australian Cancer Incidence and Mortality (ACIM) books: Breast Cancer AIHW Canberra 2016. 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