Purpose: Evaluation of a simplified intensity-modulated irradiation (IMRT), a three-field (MFT), and a conventional two-tangential-field technique regarding dose homogeneity, target coverage, feasibility and, for the first time, dosimetric reliability in patients with large breasts treated postoperatively for breast cancer on a low-energy linac. Material and Methods: CT datasets of ten patients with relatively large breast volumes treated for breast cancer were selected. For each patient, four treatment plans were created: low-energy conventional (C-LE), high-energy conventional (C-HE), three-field (MFT), and a two-field aperture-based IMRT technique. Apertures for the IMRT and MFT were created with the aid of a three-dimensional dose display. Dosimetric accuracy of each technique was evaluated in an anthropomorphic thorax/breast phantom. Results: The mean of planning target volumes receiving < 95% or > 105% of the prescribed total dose was reduced from 16.0% to 13.9% to 10.4% to 8.9% in the C-LE, C-HE, MFT, and IMRT plans, respectively. Phantom dose measurements agreed well with the calculated dose within the breast tissue. Conclusion: Aperture-based IMRT using two tangential incident beam directions, as well as a three-field technique with inverse optimization, provide a better alternative to the standard wedged tangential beams for patients with large breasts treated on low-energy linacs while maintaining the efficiency of the treatment-planning and delivery process.

Improving dose homogeneity in large breasts by IMRT - Efficacy and dosimetric accuracy of different techniques / Abo-Madyan, Y; Polednik, M; Rahn, A; Schneider, F; Dobler, B; Wenz, F; Lohr, F. - In: STRAHLENTHERAPIE UND ONKOLOGIE. - ISSN 0179-7158. - 184:2(2008), pp. 86-92. [10.1007/s00066-008-1730-9]

Improving dose homogeneity in large breasts by IMRT - Efficacy and dosimetric accuracy of different techniques

Lohr F
2008

Abstract

Purpose: Evaluation of a simplified intensity-modulated irradiation (IMRT), a three-field (MFT), and a conventional two-tangential-field technique regarding dose homogeneity, target coverage, feasibility and, for the first time, dosimetric reliability in patients with large breasts treated postoperatively for breast cancer on a low-energy linac. Material and Methods: CT datasets of ten patients with relatively large breast volumes treated for breast cancer were selected. For each patient, four treatment plans were created: low-energy conventional (C-LE), high-energy conventional (C-HE), three-field (MFT), and a two-field aperture-based IMRT technique. Apertures for the IMRT and MFT were created with the aid of a three-dimensional dose display. Dosimetric accuracy of each technique was evaluated in an anthropomorphic thorax/breast phantom. Results: The mean of planning target volumes receiving < 95% or > 105% of the prescribed total dose was reduced from 16.0% to 13.9% to 10.4% to 8.9% in the C-LE, C-HE, MFT, and IMRT plans, respectively. Phantom dose measurements agreed well with the calculated dose within the breast tissue. Conclusion: Aperture-based IMRT using two tangential incident beam directions, as well as a three-field technique with inverse optimization, provide a better alternative to the standard wedged tangential beams for patients with large breasts treated on low-energy linacs while maintaining the efficiency of the treatment-planning and delivery process.
184
2
86
92
Improving dose homogeneity in large breasts by IMRT - Efficacy and dosimetric accuracy of different techniques / Abo-Madyan, Y; Polednik, M; Rahn, A; Schneider, F; Dobler, B; Wenz, F; Lohr, F. - In: STRAHLENTHERAPIE UND ONKOLOGIE. - ISSN 0179-7158. - 184:2(2008), pp. 86-92. [10.1007/s00066-008-1730-9]
Abo-Madyan, Y; Polednik, M; Rahn, A; Schneider, F; Dobler, B; Wenz, F; Lohr, F
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11380/1172384
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