A Dosimetric Comparison of Electronic Compensation, Conventional Intensity Modulated Radiotherapy, and Tomotherapy in Patients With Early-Stage Carcinoma of the Left Breast

Caudell, Jimmy J.; Santos, Jennifer F. De Los; Keene, K.S.; Fiveash, John B.; Wang, Wenquan; Carlisle, J.; Popple, Richard A.

doi:10.1016/j.ijrobp.2007.04.026

Cited by 61 publications

(42 citation statements)

References 47 publications

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“…Field sizes, gantry angles and isocentre positions were selected to cover the whole of the breast tissue, allowing no more than 2 cm of lung in the beam'seye view (BEV). The risk of radiation pneumonitis is low using this technique [19] and our maximum lung depth is similar to that adopted in other centres [6,9,18]. Collimator twists of up to 10˚were applied to ensure that the volume of lung irradiated was uniform.…”

Section: Methodsmentioning

confidence: 91%

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Irregular surface compensation for radiotherapy of the breast: correlating depth of the compensation surface with breast size and resultant dose distribution

Emmens¹,

James²

2010

BJR

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ABSTRACT. Irregular surface compensation uses dynamic multileaf collimators to modify the fluence to an irregular surface along the cranio-caudal axis. The depth of the compensation surface can be varied by specifying a user-defined parameter called the transmission penetration depth (TPD). In our institution, a review has been carried out of 60 breast patients treated using irregular surface compensation of the tangent fields. The effect of changes in the TPD on the dose distribution was investigated, and the optimum TPD was correlated with the maximum field separation (S max ) along the posterior border. Reducing the TPD below 50% pushes the dose towards the front of the breast. This reduces hot spots at the medial and lateral regions next to the posterior border of the tangential fields, particularly for patients with large separation. In 23/60 patients, with a mean S max of 23.9 ¡ 1.6 cm, a TPD between 35% and 45% was used to reduce the proportion of the planning target volume receiving more than 107% of the prescribed dose by 3.4% ¡ 2.8%. Our department protocol states that, subject to an acceptable dose distribution, a TPD of 40% is used if S max is greater than 24 cm; for smaller separations, a TPD of 50% is used.

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Section: Methodsmentioning

confidence: 91%

“…One approach is electronic compensation of the tangent fields [9][10][11][12]18]. In this technique, dynamic multileaf collimators (MLCs) vary the fluence across each field to deliver a homogeneous dose to a compensation surface defined along the cranio-caudal axis.…”

mentioning

confidence: 99%

Irregular surface compensation for radiotherapy of the breast: correlating depth of the compensation surface with breast size and resultant dose distribution

Emmens¹,

James²

2010

BJR

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“…A general conclusion summarized from previous reports was that advanced multi-beam treatment techniques could improve target homogeneity and reduce high doses, but the distribution of low doses would rise due to increased beam angles (17,18). X-knife use non-coplanar irradiation to protect normal tissue, and then improve the targets dose.…”

Section: Discussionmentioning

confidence: 99%

Dosimetric comparison of helical tomotherapy and conventional Linac-based X-knife stereotactic body radiation therapy for primary lung cancer or pulmonary metastases

Li¹,

Yang²,

Liu³

et al. 2018

J. Thorac. Dis.

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Background: To compare helical tomotherapy (HT) with X-knife stereotactic body radiation therapy (HT-SBRT/X-SBRT) for primary or metastatic lung cancer regarding planning target volume (PTV) coverage, such as homogeneity index (HI), conformity index (CI) and dose-volume histogram (DVH) of organs at risk (OARs). Methods:We retrospectively analyzed 21 patients receiving definitive radiation treatment for non-small cell lung cancer (NSCLC) or pulmonary metastases at our institution between March 2015 and October 2016.Tumors were irradiated with 4-10 Gy per fraction in 5-15 fractions. Plans were compared according to PTV coverage and OARs sparing.Results: Significant differences between HT and X-knife were observed for both HI (P=0.003) and CI (P<0.001). The V5 (P=0.001), V10 (P=0.009), V20 (P=0.001), the mean lung dose (P=0.005) of total lung and maximum dose of the spinal cord (P=0.010) were significantly lower in the X-SBRT group than the HT-SBRT group. There were no significant differences for the V30 (P=0.075) and the mean heart dose (P=0.584) between the two groups.Conclusions: X-SBRT was dosimetrically superior to HT-SBRT, when applied in these tumors' maximum diameters <5 cm. As HT resulted in increased low-dose volume, it is essential to optimize the patient selection in order to avoid severe radiation pneumonitis in HT-SBRT.

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“…One such technique is forward planning with electronic compensation that takes into account the curvature of the body contours to provide homogenous dose to the target (Chui et al 2002, Caudell et al 2007, Emmens and James 2010, Hideki et al 2013. The method uses dynamic MLC to modulate individual beamlets across the photon fields to improve dose distributions.…”

Section: Irregular Surface Compensator (Isc)mentioning

confidence: 99%

Radiation burden from modern radiation therapy techniques including proton therapy for breast cancer treatment - clinical implications

Flejmer¹

2016

Linköping University Medical Dissertations

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A Dosimetric Comparison of Electronic Compensation, Conventional Intensity Modulated Radiotherapy, and Tomotherapy in Patients With Early-Stage Carcinoma of the Left Breast

Cited by 61 publications

References 47 publications

Irregular surface compensation for radiotherapy of the breast: correlating depth of the compensation surface with breast size and resultant dose distribution

Irregular surface compensation for radiotherapy of the breast: correlating depth of the compensation surface with breast size and resultant dose distribution

Dosimetric comparison of helical tomotherapy and conventional Linac-based X-knife stereotactic body radiation therapy for primary lung cancer or pulmonary metastases

Radiation burden from modern radiation therapy techniques including proton therapy for breast cancer treatment - clinical implications

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