Skin Surface Dose for Whole Breast Radiotherapy Using Personalized Breast Holder: Comparison with Various Radiotherapy Techniques and Clinical Experiences

Abstract

Purpose: Breast immobilization with personalized breast holder (PERSBRA) is a promising approach for normal organ protection during whole breast radiotherapy. The aim of this study is to evaluate the skin surface dose for breast radiotherapy with PERSBRA using different radiotherapy techniques. Materials and methods: We designed PERSBRA with three different mesh sizes (large, fine and solid) and applied them on an anthropomorphic(Rando) phantom. Treatment planning was generated using hybrid, intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) techniques to deliver a prescribed dose of 5000 cGy in 25 fractions accordingly. Dose measurement with EBT3 film and TLD were taken on Rando phantom without PERSBRA, large mesh, fine mesh and solid PERSBRA for (a) tumor doses, (b) surface doses for medial field and lateral field irradiation undergoing hybrid, IMRT, VMAT techniques. Results: The tumor dose deviation was less than five percent between the measured doses of the EBT3 film and the TLD among the different techniques. The application of a PERSBRA was associated with a higher dose of the skin surface. A large mesh size of PERSBRA was associated with a lower surface dose. The findings were consistent among hybrid, IMRT, or VMAT techniques. Conclusions: Breast immobilization with PERSBRA can reduce heart toxicity but leads to a build-up of skin surface doses, which can be improved with a larger mesh design for common radiotherapy techniques.

Toward a Skin Dose-Area Metric Predictive of Moist Desquamation Using In Vivo Skin Dosimetry and Skin Assessments

“…Most studies present surface dose for anthropomorphic phantoms. 10 , 25 , 26 Studies have established some correlation between calculated dose-volume statistics for the breast target volume and adverse skin reactions in external beam breast RT. 4 , 27 , 28 , 29 , 30 However, these studies do not provide any insight into tolerance doses for skin.…”

Surface dose measurement and comparison between TLD and OSLD during modified re constructive mastectomy irradiation

“…These parallel opposed tangential fields are designed to ensure adequate dose coverage of the treatment area while reducing radiation exposure to nearby healthy structures such as the heart, lungs, and opposite side breast, thus minimizing potential side effects and complications. The likelihood of developing secondary cancer increases as the received radiation dose increases [11,12]. Therefore, it is essential to measure the dose delivered to nearby normal organs.…”

Targeting the organelle for radiosensitization in cancer radiotherapy

“…Although many other innovative methods like RT combined with immunotherapy [29] made great progress in recent years, challenges like the unclear pathological mechanism for the occurrence of immune-related adverse effects [30] as well as inter-individual variability [31] remain. While different RT technologies like intensity-modulated RT, volumetric modulated arc therapy [32] and helical tomotherapy [33] enhance therapeutic effect, tumor heterogeneity and radioresistance hinder successful cancer treatment.…”