Evaluation of organ-specific peripheral doses after 2-dimensional, 3-dimensional and hybrid intensity modulated radiation therapy for breast cancer based on Monte Carlo and convolution/superposition algorithms: Implications for secondary cancer risk assessment

Joosten, A.; Matzinger, Oscar; Jeanneret‐Sozzi, Wendy; Bochud, François; Moeckli, Raphaël

doi:10.1016/j.radonc.2012.11.012

Cited by 56 publications

(57 citation statements)

References 71 publications

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“…Importantly, the degree to which commercial treatment planning systems underestimate out-of-field dose varies strongly with position and the TPS dose algorithm used. These findings are similar to that which have recently been reported for a number of different TPSs and treatment modalities (Howell et al , 2010; Joosten et al , 2013b; Schneider et al , 2013). The analytical model proposed in this work, on the other hand, continues to predict measured doses at greater accuracy out to a distance of 40 cm from the CAX.…”

Section: Resultssupporting

confidence: 91%

“…To our knowledge, no contemporary commercial treatment planning system (TPS) includes the capability to accurately predict stray dose far from the treatment field. Thus, there is a large and systematic underestimation of stray radiation exposures by commonly used clinical TPSs (Howell et al , 2010; Schneider et al , 2014; Joosten et al , 2013a) and as a result, these doses and their effects are not accurately considered during treatment.…”

Section: Introductionmentioning

confidence: 99%

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A simple and fast physics-based analytical method to calculate therapeutic and stray doses from external beam, megavoltage x-ray therapy

Jagetic

Newhauser

2015

Phys. Med. Biol.

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State-of-the-art radiotherapy treatment planning systems provide reliable estimates of the therapeutic radiation but are known to underestimate or neglect the stray radiation exposures. Most commonly, stray radiation exposures are reconstructed using empirical formulas or lookup tables. The purpose of this study was to develop the basic physics of a model capable of calculating the total absorbed dose both inside and outside of the therapeutic radiation beam for external beam photon therapy. The model was developed using measurements of total absorbed dose in a water-box phantom from a 6 MV medical linear accelerator to calculate dose profiles in both the in-plane and cross-plane direction for a variety of square field sizes and depths in water. The water-box phantom facilitated development of the basic physical aspects of the model. RMS discrepancies between measured and calculated total absorbed dose values in water were less than 9.3% for all fields studied. Computation times for 10 million dose points within a homogeneous phantom were approximately 4 minutes. These results suggest that the basic physics of the model are sufficiently simple, fast, and accurate to serve as a foundation for a variety of clinical and research applications, some of which may require that the model be extended or simplified based on the needs of the user. A potentially important advantage of a physics-based approach is that the model is more readily adaptable to a wide variety of treatment units and treatment techniques than with empirical models.

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Section: Resultssupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

A simple and fast physics-based analytical method to calculate therapeutic and stray doses from external beam, megavoltage x-ray therapy

Jagetic

Newhauser

2015

Phys. Med. Biol.

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“…Joosten et al [70] partially reported a comparison between TLD measurements in an anthropomorphic phantom and the calculated MC dose. The phantom was irradiated with a five-field technique for prostate cancer.…”

Section: Estimation Of the Dose At The Point Or Volume Of Interestmentioning

confidence: 99%

A review of uncertainties in radiotherapy dose reconstruction and their impacts on dose–response relationships

et al. 2017

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Proper understanding of the risk of radiation-induced late effects for patients receiving external photon beam radiotherapy requires the determination of reliable dose–response relationships. Although significant efforts have been devoted to improving dose estimates for the study of late effects, the most often questioned explanatory variable is still the dose. In this work, based on a literature review, we provide an in-depth description of the radiotherapy dose reconstruction process for the study of late effects. In particular, we focus on the identification of the main sources of dose uncertainty involved in this process and summarise their impacts on the dose–response relationship for radiotherapy late effects. We provide a number of recommendations for making progress in estimating the uncertainties in current studies of radiotherapy late effects and reducing these uncertainties in future studies.

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“…Several papers are published on the evaluation of peripheral and organ doses due to breast cancer radiotherapy; among those the in vivo and phantom measurements using thermo-luminescent dosimeters (TLDs), a computerized Monte Carlo (MC) technique using a mathematical phantom, and several commercial treatment planning software (TPS). [30][31][32][33] Their results vary from method to method, i.e., the peripheral dose difference between TPS and MC was reported up to 70%, 34 while the mean difference between MC out-of-field doses and TLD measurements was found 11.4% ± 5.9%. 30 The percent difference between the TPS and TLD measurement skin doses was found in the range from -15% to 44%.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of surface dose outside the treatment area for five breast cancer irradiation modalities using thermo-luminescent dosimeters

Khànal

2015

Int J Cancer Ther Oncol

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Evaluation of surface dose outside the treatment area for five breast cancer irradiation modalities using thermo-luminescent dosimeters Original Article AbstractPurpose: To measure and compare the surface dose outside the treatment area at six different points of interest (POIs) for five different breast cancer radiation treatment modalities by using thermo-luminescent dosimeters (TLDs). This experiment will evaluate the magnitude of the dose due to scatter and leakage radiation at different areas outside the target on a patient that could potentially lead, in the long term, to radiation induced secondary malignancies. Methods: TLD-100 were calibrated according to the University of Wisconsin Radiation Calibration Laboratory protocol and then used for dose measurements at selected POIs namely sternum, lower abdomen, contralateral breast, thyroid, shoulder, and eye. Twenty five breast cancer patients and the following modalities were included in this study: Strut-adjusted volume implant (SAVI), mammosite multi-lumen (ML), Accuboost, electron boost and photon boost. The surface doses in all patients were measured in a single fraction. The delivered target doses were normalized to 200 cGy. Finally, breast quadrant analysis was performed. Results: The maximum average dose for each POI was as follows: Sternum 6.51 cGy (SD 2.93), lower abdomen 4.50 cGy (SD 2.63), contralateral breast 8.52 cGy (SD 3.86), thyroid 5.50 cGy (SD 2.75), shoulder 5.58 cGy (SD 2.77), and eye 2.65 cGy (SD 0.68). The highest POI dose of 15.84 cGy was found in contralateral breast. Conclusion: The measured surface dose at each POI varies with the modality of treatment. The surface doses show a strong correlation to the tumor bed location in the breast quadrant. The SAVI, electron boost, and photon boost modalities had delivered smaller surface dose at POIs than the Accuboost and Mammosite ML modalities. While the measured doses fall within the low range, its significance in producing second malignancies would require a large cohort of patients and a longer follow up.

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Evaluation of organ-specific peripheral doses after 2-dimensional, 3-dimensional and hybrid intensity modulated radiation therapy for breast cancer based on Monte Carlo and convolution/superposition algorithms: Implications for secondary cancer risk assessment

Cited by 56 publications

References 71 publications

A simple and fast physics-based analytical method to calculate therapeutic and stray doses from external beam, megavoltage x-ray therapy

A simple and fast physics-based analytical method to calculate therapeutic and stray doses from external beam, megavoltage x-ray therapy

A review of uncertainties in radiotherapy dose reconstruction and their impacts on dose–response relationships

Evaluation of surface dose outside the treatment area for five breast cancer irradiation modalities using thermo-luminescent dosimeters

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