Isolated local chest wall relapse can be effectively controlled by wide surgical excision and perioperative reirradiation with HDR-AL. This technique may represent a treatment alternative to ultraradical surgery, with equal healing probability and a better quality of life. Small-volume irradiation of the postoperative scar can be performed with HDR-AL brachytherapy, and long-term local control can be achieved with a total dose of 30 Gy.

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The PTW EPID QC PHANTOM can be used not only for amorphous silicon EPIDs but also for images taken with a video-based system or by using an ionization chamber matrix or for portal film. For analysis of QC tests, a standardized format (used at the acceptance test) should be applied, as the results are dependent on the file format used.

The digitalization of analog simulators is a valuable updating in clinical use replacing screen-film technique. Film scanning and digitalization permit the electronic archiving of films. Conversion into DICOM RT images is a precondition of importing to the R&V system.