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Technique alternatives for breast radiation oncology: Conventional radiation therapy to tomotherapy.

Fournier-Bidoz N, Kirova Y, Campana F, El Barouky J, Zefkili S, Dendale R, Bollet MA, Mazal A, Fourquet A - J Med Phys (2009)

Bottom Line: This conventional approach can be improved by a field-in-field technique using the linac multi-leaf collimator (MLC).However, careful quality assurance of the treatment planning system must be performed.Tomotherapy is a valuable recourse for complex irradiations like bilateral breast or mammary plus axillary irradiation while a field-in-field associated with a unique isocenter technique can be used for majority of the patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Institut Curie, 26 rue d'Ulm, Paris 75005, France.

ABSTRACT
Breast conserving radiotherapy uses tangential fields and compensating wedges. This conventional approach can be improved by a field-in-field technique using the linac multi-leaf collimator (MLC). A simplified field-in-field technique that planners can easily achieve and which improves dose uniformity in the breast volume is presented here. Field junction problems are more easily solved by the use of a virtual simulation. A unique isocenter can be set at the junction between the supra-clavicular field and the breast tangential fields. However, careful quality assurance of the treatment planning system must be performed. Tomotherapy has promising clinical advantages: the ability of a tomographic image to correct for random set-up errors, a continuous cranio-caudal delivery which suppresses junction problems, the conformality of the dose distribution throughout the complex volumes formed by the lymph nodes and the breasts. Tomotherapy is a valuable recourse for complex irradiations like bilateral breast or mammary plus axillary irradiation while a field-in-field associated with a unique isocenter technique can be used for majority of the patients.

No MeSH data available.


a) Dosimetric film for a two-segment asymmetric breast field b) Superposition of calculated (plain) and measured (dashed) iso-doses
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Figure 0006: a) Dosimetric film for a two-segment asymmetric breast field b) Superposition of calculated (plain) and measured (dashed) iso-doses

Mentions: Dosimetric films can be used to compare TPS calculations and field-in-field plans delivery. Radiochromic films are easy to use as they do not need film processing. Figure 6a shows a Gafchromic film irradiated at 5cm in a flat phantom to verify the calculated dose of a breast lateral tangent containing one subfield and having an asymmetric geometry. The dose distribution in the phantom in a frontal plane is compared to the dose distribution on the film [Figure 6b].


Technique alternatives for breast radiation oncology: Conventional radiation therapy to tomotherapy.

Fournier-Bidoz N, Kirova Y, Campana F, El Barouky J, Zefkili S, Dendale R, Bollet MA, Mazal A, Fourquet A - J Med Phys (2009)

a) Dosimetric film for a two-segment asymmetric breast field b) Superposition of calculated (plain) and measured (dashed) iso-doses
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2807680&req=5

Figure 0006: a) Dosimetric film for a two-segment asymmetric breast field b) Superposition of calculated (plain) and measured (dashed) iso-doses
Mentions: Dosimetric films can be used to compare TPS calculations and field-in-field plans delivery. Radiochromic films are easy to use as they do not need film processing. Figure 6a shows a Gafchromic film irradiated at 5cm in a flat phantom to verify the calculated dose of a breast lateral tangent containing one subfield and having an asymmetric geometry. The dose distribution in the phantom in a frontal plane is compared to the dose distribution on the film [Figure 6b].

Bottom Line: This conventional approach can be improved by a field-in-field technique using the linac multi-leaf collimator (MLC).However, careful quality assurance of the treatment planning system must be performed.Tomotherapy is a valuable recourse for complex irradiations like bilateral breast or mammary plus axillary irradiation while a field-in-field associated with a unique isocenter technique can be used for majority of the patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Institut Curie, 26 rue d'Ulm, Paris 75005, France.

ABSTRACT
Breast conserving radiotherapy uses tangential fields and compensating wedges. This conventional approach can be improved by a field-in-field technique using the linac multi-leaf collimator (MLC). A simplified field-in-field technique that planners can easily achieve and which improves dose uniformity in the breast volume is presented here. Field junction problems are more easily solved by the use of a virtual simulation. A unique isocenter can be set at the junction between the supra-clavicular field and the breast tangential fields. However, careful quality assurance of the treatment planning system must be performed. Tomotherapy has promising clinical advantages: the ability of a tomographic image to correct for random set-up errors, a continuous cranio-caudal delivery which suppresses junction problems, the conformality of the dose distribution throughout the complex volumes formed by the lymph nodes and the breasts. Tomotherapy is a valuable recourse for complex irradiations like bilateral breast or mammary plus axillary irradiation while a field-in-field associated with a unique isocenter technique can be used for majority of the patients.

No MeSH data available.