Comparison of skin doses of treated and contralateral breasts during whole breast radiotherapy for different treatment techniques using optically stimulated luminescent dosimeters

2020 ◽  
pp. 1-7
Author(s):  
Zhenia Gopalakrishnan ◽  
RaghuRam K. Nair ◽  
P. Raghukumar ◽  
Saju Bhasi ◽  
Sharika V. Menon
Keyword(s):  
Treatment Planning ◽  
Left Breast ◽  
Ct Images ◽  
Breast Radiotherapy ◽  
Treatment Techniques ◽  
Whole Breast Radiotherapy ◽  
Measured Dose ◽  
Breast Phantom ◽  
Skin Doses ◽  
Optically Stimulated Luminescent Dosimeters

Abstract Purpose: To measure and compare the skin doses received by treated left breast and contralateral breast (CB) during whole breast radiotherapy using five treatment techniques in an indigenously prepared wax breast phantom. Materials and methods: Computed tomography (CT) images of the breast phantom were used for treatment planning and comparison of skin dose calculated from treatment planning system (TPS) with measured dose. Planning target volume (PTV) and the CB were drawn arbitrarily on the CT images acquired for the breast phantom with 10 numbers of calibrated optically stimulated luminescent dosimeters (OSLDs) fixed on the surface of both breasts. The TPS calculated surface doses of PTV breast and CB for five treatment planning techniques, viz., conventional wedge (CW), irregular surface compensator-based (ISC), field-in-field (FiF), intensity-modulated radiotherapy (IMRT) and rapid arc (RA) techniques were obtained for comparison. The plans were executed in Clinac iX Linear Accelerator with the OSLDs fixed at the same locations on the phantom as in simulation. The TPS calculated mean dose at the surface of the treated left breast and CB was noted for the 10 OSLDs from dose-volume histogram (DVH) and compared with the measured dose. Also, the mean chamber dose at the centre of the left breast was noted from the DVH for comparing with ion chamber measured dose. Results: With reference to the results, it is seen that the dose to the CB is lowest in ISC technique and FiF technique and greatest in IMRT technique. The CW technique also delivered a dose comparable to IMRT to the CB of the phantom. The dose to the surface of PTV breast was highest and comparable in CW plans and FiF plans (68% and 67%) and lowest in IMRT and RA plans (50% each). Findings: Analysis of the results shows that the FiF and ISC techniques are preferred while planning breast radiotherapy due to the reduced dose to the CB.

Dose calculation accuracies in whole breast radiotherapy treatment planning: a multi-institutional study

2015 ◽  
Vol 8 (2) ◽  
pp. 200-208 ◽  
Author(s):  
Shogo Hatanaka ◽  
Yuki Miyabe ◽  
Naoki Tohyama ◽  
Yu Kumazaki ◽  
Masahiko Kurooka ◽  
...  
Keyword(s):  
Treatment Planning ◽  
Dose Calculation ◽  
Breast Radiotherapy ◽  
Radiotherapy Treatment Planning ◽  
Whole Breast Radiotherapy ◽  
Radiotherapy Treatment

A treatment planning study using non-coplanar static fields and coplanar arcs for whole breast radiotherapy of patients with concave geometry

2007 ◽  
Vol 85 (3) ◽  
pp. 346-354 ◽  
Author(s):  
Antonella Fogliata ◽  
Alessandro Clivio ◽  
Giorgia Nicolini ◽  
Eugenio Vanetti ◽  
Luca Cozzi
Keyword(s):  
Treatment Planning ◽  
Planning Study ◽  
Breast Radiotherapy ◽  
Whole Breast Radiotherapy

scholarly journals Adjuvant Whole Breast Radiotherapy Improve Survival in Women with Heart Failure with Reduced Ejection Fraction Receiving Breast-Conserving Surgery

2021 ◽  
Author(s):  
Jiaqiang Zhang ◽  
Shao-Yin Sum ◽  
Jeng-Guan Hsu ◽  
Ming-Feng Chiang ◽  
Tian-Shyug Lee ◽  
...  
Keyword(s):  
Heart Failure ◽  
Propensity Score ◽  
Ejection Fraction ◽  
Breast Conserving Surgery ◽  
Left Breast ◽  
Oncologic Outcomes ◽  
Study Cohort ◽  
Breast Radiotherapy ◽  
Reduced Ejection Fraction ◽  
Whole Breast Radiotherapy

Abstract BACKGROUND: To date, no data on the effect of adjuvant whole breast radiotherapy (WBRT) on oncologic outcomes, such as all-cause death, locoregional recurrence (LRR), and distant metastasis (DM), are available in women with left-side breast intraductal carcinoma (IDC) and heart failure with reduced ejection fraction (HFrEF). PATIENTS AND METHODS: We enrolled 294 women with left-breast IDC at clinical stages IA–IIIC and HFrEF receiving breast-conserving surgery (BCS) followed by adjuvant WBRT or non-adjuvant WBRT. We categorized them into two groups based on their adjuvant WBRT status and compared their overall survival (OS), LRR, and DM outcomes. We calculated the propensity score and applied inverse probability of treatment weighting (IPTW) to create a pseudo-study cohort. Furthermore, we performed a multivariate analysis of the propensity score–weighted population to obtain hazard ratios (HRs).RESULTS: In the IPTW-adjusted model, adjuvant WBRT (adjusted HR [aHR]: 0.58; 95% confidence interval [CI]: 0.33–1.00) was a significant independent prognostic factor for all-cause death (P = 0.0494), and the aHR (95% CI) of LRR and DM for adjuvant WBRT was 0.25 (0.10–0.62; P = 0.0028) and 0.29 (0.14–0.60; P = 0.0007), respectively, compared with the nonadjuvant WBRT group. CONCLUSION: Adjuvant WBRT was associated with a decrease in all-cause death, LRR, and DM in women with left IDC and HFrEF compared with nonadjuvant WBRT.

scholarly journals Breath Hold Breast Radiotherapy In The Era of Precision Medicine: Appropriate Selection for Left Descending Artery Sparing

2020 ◽  
Author(s):  
Edy Ippolito ◽  
Carlo Greco ◽  
Maristella Marrocco ◽  
Silvia Gentile ◽  
Serena Palizza ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Minimum Distance ◽  
Free Breathing ◽  
Left Breast ◽  
Breath Hold ◽  
Operating Characteristics ◽  
Breast Radiotherapy ◽  
Heart Volume ◽  
Deep Inspiration Breath Hold ◽  
Whole Breast Radiotherapy

Abstract Background and purpose To identify anatomical and/or preplanning characteristics correlated with left descending artery (LAD) dose and therefore provide guidance in the selection of patients with left-breast cancer that could benefit the most from the use of deep inspiration breath hold radiotherapy (DIBH-RT). Materials and methods We retrospectively identified patients with left-sided breast cancer who underwent whole breast radiotherapy in DIBH and extracted data from treatment plans in free-breathing (FB) and DIBH. The following anatomical parameters were obtained from the planning CTs in FB: lung volume, heart volume, breast separation, minimum distance from LAD to tangent open field. Receiving operating characteristics was also performed to define the cut-off point of parameters to use in LAD dosimetry prediction. Areas under the curve (AUCs) were calculated for all variables. Post-test probability has been calculated to evaluate advantage for parameters combination. Results One hundred ninety-seven patients were identified. The strongest predictor at FB CT scan of LAD maximum dose > 10 Gy and a LAD mean dose > 4 Gy was the minimum distance of LAD from tangent open fields. Adding consecutively other preplanning anatomic parameters, the positive predictive value (PPV) to identify patients at risk of higher dose to LAD was > 90%. Conclusions The dosimetric benefit of DIBH is valid for all patients and DIBH should be preferred for all left sided patients; however we can identify a subgroup of patients who benefit the least from DIBH. This is the group with favorable anatomy: limited breast separation, well expanded lungs, LAD distant from open tangent fields.

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