Superficial doses in breast cancer radiotherapy using conventional and IMRT techniques: A film-based phantom study

Almberg, Sigrun Saur; Lindmo, Tore; Frengen, Jomar

doi:10.1016/j.radonc.2011.05.021

Cited by 32 publications

(21 citation statements)

References 24 publications

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“…Our results are in excellent agreement with a film-based phantom study using an anthropomorphic female thorax phantom and GafChromic films for the dose measurements [19]. In agreement with our study, tangential irradiation resulted in surface doses mainly within 45–65% of the target dose (our study: 40-60%).…”

Section: Discussionsupporting

confidence: 91%

In vivo surface dose measurement using GafChromic film dosimetry in breast cancer radiotherapy: comparison of 7-field IMRT, tangential IMRT and tangential 3D-CRT

et al. 2014

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PurposeThe purpose of this study was to compare the surface dose of 7-field IMRT (7 F-IMRT), tangential beam IMRT (TB-IMRT), and tangential beam 3D-CRT (3D-CRT) of breast cancer patients receiving adjuvant radiotherapy by means of in vivo GafChromic film dosimetry.Material and methodsBreast cancer patients receiving adjuvant radiotherapy of the whole breast or the chest wall were eligible for the study. Study patients were treated with a treatment plan using two different radiotherapy techniques (first patient series, 3D-CRT followed by TB-IMRT; second patient series, TB-IMRT followed by 7 F-IMRT). The surface dose was evaluated on three consecutive treatment fractions per radiotherapy technique using in vivo GafChromic film dosimetry. The paired t-test was used to assess the difference of in vivo GafChromic film readings or calculated plan parameters of the compared pairs of radiation techniques for statistical significance.ResultsForty-five unselected breast cancer patients were analysed in this study. 7 F-IMRT significantly reduced the surface dose compared to TB-IMRT. Differences were greatest in the central and lateral breast or chest wall region and amounted to a dose reduction of -11.8% to -18.8%. No significant difference of the surface dose was observed between TB-IMRT and 3D-CRT. A corresponding observation was obtained for the calculated skin dose derived from dose-volume histograms.ConclusionsIn adjuvant breast cancer radiotherapy, 7 F-IMRT offers a significantly reduced surface dose compared to TB-IMRT or 3D-CRT.

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Section: Discussionsupporting

confidence: 91%

In vivo surface dose measurement using GafChromic film dosimetry in breast cancer radiotherapy: comparison of 7-field IMRT, tangential IMRT and tangential 3D-CRT

et al. 2014

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“…4–7 IMRT facilitates to achieve a more homogeneous dose distribution and to decrease normal tissue irradiation by providing more degrees of freedom in the planning process. Nevertheless, the influence of target motion on dose homogeneity and conformity degree will be increased with the increase of beam on times (BOT) for static gantry IMRT.…”

Section: Introductionmentioning

confidence: 99%

Modified Volumetric Modulated Arc Therapy in Left Sided Breast Cancer After Radical Mastectomy With Flattening Filter Free Versus Flattened Beams

Lai

Chen

et al. 2016

Medicine

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Conventional volumetric modulated arc therapy (C-VMAT) for breast cancer after radical mastectomy had its limitation that resulted in larger volumes of normal tissue receiving low doses. We explored whether there was a way to deal with this disadvantage and determined the potential benefit of flattening filter-free (FFF) beams.Twenty patients with breast cancer after radical mastectomy were subjected to 3D conformal radiotherapy (3DCRT) and VMAT treatment planning. For VMAT plans, 3 different designs were employed with RapidArc form: conventional-VMAT plan (C-VMAT), modified-VMAT plan (M-VMAT), and modified-VMAT plan using FFF beams (M-VMAT-F). Plan quality and efficiency were assessed for all plans.For each technique in homogeneity, there were no statistically significant differences. VMAT plans showed superiority compared with 3DCRT in conformity. C-VMAT plans were obviously not only superior to 3DCRT in the medium to high-dose regions (about 15–50 Gy) but also resulted in larger volumes in low-dose regions (about 0–10 Gy). M-VMAT plans were similar to M-VMAT-F. Both of them might significantly reduce the regions of low dose compared with C-VMAT (V5lung: ∼ 11.5%; V5heart: ∼ 23.8%, P < 0.05), even less than 3DCRT in heart irradiation (V2.5heart, 9.4%, P < 0.05). For liver, contralateral breast, and lung irradiation, M-VMAT-F plans were slightly superior to M-VMAT with a reduction of ∼0.08, 0.2, and 0.24 Gy in the respective mean doses (P < 0.05).C-VMAT plans showed superiority compared with 3DCRT, while also resulted in larger volumes of normal tissue receiving low doses. M-VMAT and M-VMAT-F plans might not only reduce the region in the medium to high doses but also have lower volumes in low-dose regions. M-VMAT-F plans were slightly superior compared with M-VMAT due to further contralateral organs sparing.

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“…However, it is known that most dose calculation algorithms cannot calculate dose distributions in areas where electron equilibrium is not established. 10 Various studies have investigated the dose distribution of breast radiotherapy using film measurement; in some of these, films were placed between sliced phantoms and the dose distribution of the cross section was measured, [11][12][13] others used EBT films for surface dose measurement, [14][15][16] but did not compare the measured dose with the dose calculated by TPS. When an irradiated film is scanned with a flat-bed scanner, only two-dimensional data can be obtained.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of superficial dosimetry between treatment planning system and measurement for several breast cancer treatment techniques

et al. 2012

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In general, TPS even with advanced algorithms do not provide accurate dosimetry in the buildup region, as verified by EBT2 film for all treatment techniques. For all cases, TPS and measured doses were in agreement from 6 mm in depth but differed at shallower depths. Grid size plays an important role in dose calculation. For accurate dosimetry small grid size should be used where differences are lower between TPS and measurements.

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Superficial doses in breast cancer radiotherapy using conventional and IMRT techniques: A film-based phantom study

Cited by 32 publications

References 24 publications

In vivo surface dose measurement using GafChromic film dosimetry in breast cancer radiotherapy: comparison of 7-field IMRT, tangential IMRT and tangential 3D-CRT

In vivo surface dose measurement using GafChromic film dosimetry in breast cancer radiotherapy: comparison of 7-field IMRT, tangential IMRT and tangential 3D-CRT

Modified Volumetric Modulated Arc Therapy in Left Sided Breast Cancer After Radical Mastectomy With Flattening Filter Free Versus Flattened Beams

Evaluation of superficial dosimetry between treatment planning system and measurement for several breast cancer treatment techniques

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