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Forward-planned intensity modulated radiation therapy using a cobalt source: A dosimetric study in breast cancer.

Cilla S, Kigula-Mugambe J, Digesù C, Macchia G, Bogale S, Massaccesi M, Dawotola D, Deodato F, Buwenge M, Caravatta L, Piermattei A, Valentini V, Morganti AG - J Med Phys (2013)

Bottom Line: Co-FinF technique improved the planning target volume dose homogeneity compared to other cobalt-based techniques and reduced maximum doses (D2%) and high-dose volume (V110%).Moreover, it showed a better lung and heart dose sparing with respect to the standard approach.The higher dose homogeneity may encourage the adoption of accelerated-hypofractionated treatments also with the cobalt sources.

View Article: PubMed Central - PubMed

Affiliation: Medical Physics Unit, Fondazione di Ricerca e Cura "Giovanni Paolo II", Università Cattolica del Sacro Cuore, Campobasso, Italy.

ABSTRACT
This analysis evaluates the feasibility and dosimetric results of a simplified intensity-modulated radiotherapy (IMRT) treatment using a cobalt-therapy unit for post-operative breast cancer. Fourteen patients were included. Three plans per patient were produced by a cobalt-60 source: A standard plan with two wedged tangential beams, a standard tangential plan optimized without the use of wedges and a plan based on the forward-planned "field-in-field" IMRT technique (Co-FinF) where the dose on each of the two tangential beams was split into two different segments and the two segments weight was determined with an iterative process. For comparison purposes, a 6-MV photon standard wedged tangential treatment plan was generated. Dmean, D98%, D2%, V95%, V107%, homogeneity, and conformity indices were chosen as parameters for comparison. Co-FinF technique improved the planning target volume dose homogeneity compared to other cobalt-based techniques and reduced maximum doses (D2%) and high-dose volume (V110%). Moreover, it showed a better lung and heart dose sparing with respect to the standard approach. The higher dose homogeneity may encourage the adoption of accelerated-hypofractionated treatments also with the cobalt sources. This approach can promote the spread of breast conservative treatment in developing countries.

No MeSH data available.


Related in: MedlinePlus

Dose distribution (V95%, green; V105%, yellow; V110%, orange and V115%, red) for (a) Co-OF, (b) Co-WF, (c) Co-FinF and (d) 6MV-conformal radiotherapy on the axial and coronal plane containing isocenter
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Figure 3: Dose distribution (V95%, green; V105%, yellow; V110%, orange and V115%, red) for (a) Co-OF, (b) Co-WF, (c) Co-FinF and (d) 6MV-conformal radiotherapy on the axial and coronal plane containing isocenter

Mentions: Figure 3 shows the dose distribution for one representative patient in terms of isodoses equal to 95%, 105%, 110%, and 115% of the prescribed dose on the axial slice and coronal view containing isocenter. The advantages of Co-FinF are clearly evident in terms of reduction of areas irradiated at high doses, which are mainly present in the breast anterior region for Co-OF technique and in the breast portion close to the lung for the Co-WF technique.


Forward-planned intensity modulated radiation therapy using a cobalt source: A dosimetric study in breast cancer.

Cilla S, Kigula-Mugambe J, Digesù C, Macchia G, Bogale S, Massaccesi M, Dawotola D, Deodato F, Buwenge M, Caravatta L, Piermattei A, Valentini V, Morganti AG - J Med Phys (2013)

Dose distribution (V95%, green; V105%, yellow; V110%, orange and V115%, red) for (a) Co-OF, (b) Co-WF, (c) Co-FinF and (d) 6MV-conformal radiotherapy on the axial and coronal plane containing isocenter
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3775036&req=5

Figure 3: Dose distribution (V95%, green; V105%, yellow; V110%, orange and V115%, red) for (a) Co-OF, (b) Co-WF, (c) Co-FinF and (d) 6MV-conformal radiotherapy on the axial and coronal plane containing isocenter
Mentions: Figure 3 shows the dose distribution for one representative patient in terms of isodoses equal to 95%, 105%, 110%, and 115% of the prescribed dose on the axial slice and coronal view containing isocenter. The advantages of Co-FinF are clearly evident in terms of reduction of areas irradiated at high doses, which are mainly present in the breast anterior region for Co-OF technique and in the breast portion close to the lung for the Co-WF technique.

Bottom Line: Co-FinF technique improved the planning target volume dose homogeneity compared to other cobalt-based techniques and reduced maximum doses (D2%) and high-dose volume (V110%).Moreover, it showed a better lung and heart dose sparing with respect to the standard approach.The higher dose homogeneity may encourage the adoption of accelerated-hypofractionated treatments also with the cobalt sources.

View Article: PubMed Central - PubMed

Affiliation: Medical Physics Unit, Fondazione di Ricerca e Cura "Giovanni Paolo II", Università Cattolica del Sacro Cuore, Campobasso, Italy.

ABSTRACT
This analysis evaluates the feasibility and dosimetric results of a simplified intensity-modulated radiotherapy (IMRT) treatment using a cobalt-therapy unit for post-operative breast cancer. Fourteen patients were included. Three plans per patient were produced by a cobalt-60 source: A standard plan with two wedged tangential beams, a standard tangential plan optimized without the use of wedges and a plan based on the forward-planned "field-in-field" IMRT technique (Co-FinF) where the dose on each of the two tangential beams was split into two different segments and the two segments weight was determined with an iterative process. For comparison purposes, a 6-MV photon standard wedged tangential treatment plan was generated. Dmean, D98%, D2%, V95%, V107%, homogeneity, and conformity indices were chosen as parameters for comparison. Co-FinF technique improved the planning target volume dose homogeneity compared to other cobalt-based techniques and reduced maximum doses (D2%) and high-dose volume (V110%). Moreover, it showed a better lung and heart dose sparing with respect to the standard approach. The higher dose homogeneity may encourage the adoption of accelerated-hypofractionated treatments also with the cobalt sources. This approach can promote the spread of breast conservative treatment in developing countries.

No MeSH data available.


Related in: MedlinePlus