Dosimetric improvements following 3D planning of tangential breast irradiation

Aref, Amr; Thornton, Dale; Youssef, Emad; He, T.; Tekyi-Mensah, Samuel; Denton, L; Ezzell, Gary A.

doi:10.1016/s0360-3016(00)00808-7

Cited by 51 publications

(17 citation statements)

References 13 publications

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“…It has been shown that dose-based compensation can improve dose homogeneity within the breast compared with standard wedged deliveries [1][2][3][4][5][6][7][8][9][10][11][12]. Minimising dose inhomogeneities can reduce late adverse effects such as changes in breast cosmesis, induration and acute toxicity [13][14][15], particularly in women with large breasts, for whom inferior cosmetic outcomes using the standard wedged technique have been reported [16,17].…”

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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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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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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“…19 Computed tomography is currently being used, as described later, to simulate radiation therapy, thereby allowing avoidance of radiation exposure to the lung and heart, the correction of underlying lung density, and optimization of compensation. 20,21 Although early complications of breast irradiation, including skin erythema and irritation, are commonly BCT, breast-conserving therapy; XRT, X-ray therapy; Lump, lumpectomy observed, they minimally influence the patient's quality of life. 22 In addition, general malaise is occasionally noted.…”

Section: Significance and Complications Of Breast Irradiationmentioning

confidence: 99%

Radiation therapy after breast-conserving surgery

et al. 2006

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The authors critically reviewed previous articles concerning the significance of breast irradiation following breast-conserving surgery in terms of the following subject items: indications for breast-conserving therapy, the significance and complications of breast irradiation, the timing of the start of breast irradiation, the significance of boost irradiation, the potential improvement of survival with systemic therapy plus breast irradiation, the significance of axillary dissection, indications and the significance of regional nodal irradiation, accelerated hypofractionated radiotherapy, omission of breast irradiation in low-risk patients, and future directions. In addition, our previously reported results of breast irradiation following breast-conserving surgery at the Keio University Hospital are outlined. Our newly developed tangential irradiation technique directed to the axilla and a recently introduced three-dimensional simulation technique for radiotherapy treatment planning are also presented.

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“…[1][2][3] The most commonly used technique is opposed tangential external beams to cover all the potential tumor-bearing chest wall tissues. 4 A supraclavicular fi eld may be needed to adequately cover the regional nodes, if they are at risk.…”

Section: Introductionmentioning

confidence: 99%