Feasibility of commercially available underwear during radiation therapy for breast cancer: build-up and surface dose measurements

2021 ◽  
pp. 1-2
Author(s):  
Yukihiro Hama
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Phantom Study ◽  
Surface Dose ◽  
Receive Radiation Therapy ◽  
Dose Increase ◽  
Increase Rate ◽  
The Mean ◽  
Skin Doses ◽  
Dose Measurements

Abstract Aim: When patients receive radiation therapy for breast cancer, they need to take off their underwear to avoid build-up effects. However, it is a mental burden for female patients to take off their underwear at every fraction of radiation therapy. The purpose of this study was to investigate whether commercially available thin underwear can be worn during radiation therapy for breast cancer. Materials and methods: In this phantom study, we investigated whether commercially available underwear can be worn during radiation therapy for breast cancer using six thin non-disposable brassieres and one disposable paper brassiere. The dose increase rate (ΔD) was calculated by measuring skin doses with or without each brassiere. Results: The mean ΔD values of six non-disposable brassieres were 13.5% (9.0–21.8%), whereas that of disposable ones was 2.0%. Findings: Due to the risk of excessive radiation to the skin, wearing commercially available underwear is not recommended during radiation therapy for breast cancer, but a thin disposable paper brassiere may be safe to be used.

Evaluation of thermoplastic Klarity mask use during intensity-modulated radiation therapy for head and neck carcinoma

2018 ◽  
Vol 17 (2) ◽  
pp. 171-178 ◽  
Author(s):  
Khaldoon Radaideh
Keyword(s):  
Radiation Therapy ◽  
Head And Neck ◽  
Intensity Modulated Radiation Therapy ◽  
Planning System ◽  
Skin Dose ◽  
Surface Dose ◽  
Thermoluminescent Dosimeters ◽  
Intensity Modulated ◽  
Skin Doses ◽  
Dose Measurements

AbstractAimTo evaluate the Klarity® Mask with respect to skin doses and toxicity secondary to head and neck cancer radiation treatment.Materials and methodsThis prospective study included five nasopharyngeal cancer patients who underwent intensity-modulated radiation therapy and monitored for skin toxicity. An anatomical Perspex head and neck phantom was designed and used. All patients’ treatment plans were separately transferred to the phantom. Dosimetric measurements were performed using chip-shaped thermoluminescent dosimeters (LiF:Mg,Ti TLDs) which were distributed at certain target points on the phantom. Phantom was irradiated twicely with and without a Klarity® Mask. Three fractions for each patient plan were obtained and compared with treatment planning system (TPS) doses as guided by computed tomography.ResultsThe Klarity mask used for patient immobilisation increased the surface dose by 10·83% more than that without the mask. The average variations between skin dose measurements with and without the Klarity mask for all patients’ plans ranged from 10·26 to 11·83%. TPS overestimated the surface dose by 19·13% when compared with thermoluminescent dosimeters that measured the direct skin dose.ConclusionsKlarity immobilisation mask increases skin doses, as a consequence, surface dose measurements should be monitored and must be taken into account.

PO-1346: In-vivo surface dose measurements in breast cancer patient treated with helical radiation therapy

2020 ◽  
Vol 152 ◽  
pp. S712-S713
Author(s):  
M. Valenti ◽  
M. Parisotto ◽  
F. Angeletti ◽  
F. Cucciarelli ◽  
G. Mantello ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Cancer Patient ◽  
Breast Cancer Patient ◽  
Surface Dose ◽  
Dose Measurements

scholarly journals Dose Volume Relationship in Estimating Cardiac Doses in Breast Cancer Radiotherapy

2020 ◽  
Author(s):  
Lucy Pattanayak ◽  
Swodeep Mohanty ◽  
Deepak Kumar Sahu ◽  
Tapas Kumar Dash ◽  
Itishree Priyadarsini
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Conformal Radiotherapy ◽  
Free Breathing ◽  
P Value ◽  
Carcinoma Breast ◽  
Heart Dose ◽  
Cardiac Dose ◽  
The Mean ◽  
Mean Heart Dose

Introduction: Radiation therapy is an integral part of adjuvant treatment for breast cancer which reduces local recurrence and significantly increases survival. But, radiation therapy also has the propensity to increase cardiac morbidity and mortality due to dose received by the heart which is more in left-sided breast cancer. Mean Heart dose and Maximum Heart Distance (MHD) are two parameters to study dose received by the heart. Aim: The purpose of this study was to determine individual doses received by the heart and to correlate MHD with the mean heart dose received by heart in carcinoma breast patients receiving radiotherapy. Materials and Methods: Ninety patients of histologically proven carcinoma breast who attended the Department of Radiotherapy, Acharya Harihar Regional Cancer, Cuttack from January 2017 to January 2019 were selected for a prospective observational study. All patients were treated with 3D Conformal Radiotherapy technique using free breathing multi slice Computed Tomography (CT) scans to contour target and vital organs. Parallel opposed tangential treatment plans were generated for each patient. Individual dose received by the heart and MHD was assessed for each case. SPSS version 21 used for statistical analysis. The Spearman’s Rho test was used for correlation of MHD with Mean heart dose. The Mann-Whitney U test was used for comparing mean of MHD in left-sided and right-sided breast cancer. The Independent t-test was used for comparing means of Mean heart dose in left-sided and right-sided breast cancer. A p-value <0.05 was considered as statistically significant. Results: The Mean Heart Dose was 4.63 Gy for left-sided breast carcinoma patients and 0.846 Gy for right-sided breast cancer and there was a significant difference (p<0.001). Mean MHD for left-sided breast cancer was 2.974 cm while for right-sided it was 0.017 cm, the difference was statistically significant (p-value <0.001). MHD also correlated positively with Mean Heart Dose with correlation coefficient of 0.849 and p-value <0.001. Conclusion: MHD and Mean Heart dose were significantly higher in left-sided breast cancer receiving radiotherapy. MHD was also found to be positively related to Mean Heart dose and therefore found to be an important predictor of cardiac dose. For right-sided breast carcinoma receiving radiotherapy, free breathing technique using 3-Dimensional Conformal Radiotherapy (3DCRT) will suffice in terms of cardiac dose.

The use of bioelectrical impedance spectroscopy (BIS) to detect subclinical changes potentially associated with the development of breast cancer-related lymphedema.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 89-89
Author(s):  
Frank Vicini ◽  
Douglas W. Arthur ◽  
Maureen Lyden ◽  
Chirag Shah
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Extracellular Fluid ◽  
Bioelectrical Impedance ◽  
Locoregional Therapy ◽  
Clinical Practices ◽  
Fluid Accumulation ◽  
The Mean ◽  
Breast Cancer Related Lymphedema ◽  
Clinical Changes

89 Background: The purpose of the study was to evaluate bioelectrical impedance spectroscopy's (BIS) ability to detect and monitor extracellular fluid accumulation of the upper limb as it relates to the extent of locoregional therapy for patients with breast cancer. Methods: A total of 125 patients from 4 clinical practices, with newly diagnosed breast cancer were evaluated at baseline and following locoregional procedures that could potentially affect fluid accumulation in the arm and signal the possible development of early lymphedema. In order to assess the ability of BIS to detect sub-clinical changes by treatment modality, the change in L-Dex score from baseline to measurements taken within 180 days following surgery were calculated. Results: Fifty-one patients (40.8%) underwent lumpectomy and 74 (59.2%) mastectomy; 68 patients (54.4%) underwent sentinel lymph node (SLN) sampling. Sixty-five patients underwent radiation therapy (RT) with RT patients being more likely to have undergone lumpectomy (66.2% v. 3.2%, p<0.001) and axillary dissection (41.5% v. 19.4%, p=0.04) compared with patients not receiving RT. However, no difference in the mean number of nodes sampled (7.7 v. 5.4, p=0.14) was noted for patients receiving RT compared with those not receiving RT. Patients receiving RT had a significantly increased change in L-Dex score (0.8 v. -2.5, p=0.03) compared with those patients not receiving RT. For all patients, ALND was associated with a significantly increased change in L-Dex score (5.0 v. 0.3, p=0.003) compared with SLN. When stratifying by the number of nodes removed, a statistically significant increase in the change in L-Dex score was noted (0.4 v. 0.4 v. 4.3 v. 6.4, p=0.04) for 0-3, 4-6, 7-10, and greater than 10 lymph nodes removed. Conclusions: In this limited analysis, L-Dex scores paralleled the extent of axillary sampling and the addition of radiation therapy; these results suggest that BIS can be used to monitor patients for the early onset of edema as differences emerged within 180 days of surgery.

Dosimetric evaluation of 3 and/or 4 field radiation therapy of breast cancers: clinical experience

2020 ◽  
pp. 1-15
Author(s):  
Ernest Osei ◽  
Susan Dang ◽  
Johnson Darko ◽  
Katrina Fleming ◽  
Ramana Rachakonda
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
High Risk ◽  
Chest Wall ◽  
Treatment Plan ◽  
Breath Hold ◽  
Adjuvant Radiation ◽  
Node Positive ◽  
Treatment Plans ◽  
The Mean

Abstract Background: Breast cancer is the most commonly diagnosed cancer among women and the second leading cause of cancer-related death in Canadian women. Surgery is often the first line of treatment for low-risk early stage patients, followed by adjuvant radiation therapy to reduce the risk of local recurrence and prevent metastasis after lumpectomy or mastectomy. For high-risk patients with node positive disease or are at greater risk of nodal metastasis, radiation therapy will involve treatment of the intact breast or chest-wall as well as the regional lymph nodes. Materials and methods: We retrospectively evaluated the treatment plans of 354 patients with breast cancer with nodes positive or were at high risk of nodal involvement treated at our cancer centre. All patients were treated with a prescription dose of 50 Gy in 25 fractions to the intact breast or chest-wall and 50 Gy in 25 fractions to the supraclavicular region and, based on patient suitability and tolerance, were treated either using the deep inspiration breath hold (DIBH) or free-breathing (FB) techniques. Results: Based on patient suitability and tolerance, 130 (36·7%) patients were treated with DIBH and 224 (63·3%) with FB techniques. There were 169 (47·7%) patients treated with intact breast, whereas 185 (52·3%) were treated for post-mastectomy chest-wall. The mean PTV_eval V92%, V95%, V100% and V105% for all patients are 99·4 ± 0·7, 97·6 ± 1·6, 74·8 ± 7·9 and 1·5 ± 3·2%, respectively. The mean ipsilateral lung V10Gy, V20Gy and V30Gy are 30·0 ± 5·3, 22·4 ± 4·7 and 18·4 ± 4·3% for intact breast and 30·9 ± 5·8, 23·5 ± 5·4 and 19·4 ± 5·0% for post-mastectomy patients with FB, respectively. The corresponding values for patients treated using DIBH are 26·3 ± 5·9, 18·9 ± 5·0 and 15·6 ± 4·7% for intact breast and 27·5 ± 6·5, 20·6 ± 5·7 and 17·1 ± 5·2% for post-mastectomy patients, respectively. The mean heart V10Gy, V20Gy, is 1·8 ± 1·7, 0·9 ± 1·0 for intact breast and 3·1 ± 2·2, 1·7 ± 1·6 for post-mastectomy patients with FB, respectively. The corresponding values with the DIBH are 0·5 ± 0·7, 0·1 ± 0·4 for intact breast and 1·1 ± 1·4, 0·4 ± 0·7 for post-mastectomy patients, respectively. Conclusion: The use of 3 and/or 4 field hybrid intensity-modulated radiation therapy technique for radiation therapy of high-risk node positive breast cancer patients provides an efficient and reliable method for achieving superior dose uniformity, conformity and homogeneity in the breast or post-mastectomy chest-wall volume with minimal doses to the organs at risk. The development and implementation of a consistent treatment plan acceptability criteria in radiotherapy programmes would establish an evaluation process to define a consistent, standardised and transparent treatment path for all patients that would reduce significant variations in the acceptability of treatment plans.

Skin dose measurement and estimating the dosimetric effect of applicator misplacement in gynecological brachytherapy: A patient and phantom study

2021 ◽  
pp. 1-13
Author(s):  
Mehrsa Majdaeen ◽  
Masoumeh Dorri—Giv ◽  
Shaghayegh Olfat ◽  
Gholamreza Ataei ◽  
Razzagh Abedi-Firouzjah ◽  
...  
Keyword(s):  
Dose Calculation ◽  
Planning System ◽  
Treatment Planning System ◽  
Future Research ◽  
Skin Dose ◽  
Surface Dose ◽  
Dose Measurement ◽  
Left And Right ◽  
The Mean ◽  
Skin Doses

OBJECTIVES: To evaluate skin dose differences between TPS (treatment planning system) calculations and TLD (thermo-luminescent dosimeters) measurements along with the dosimetric effect of applicator misplacement for patients diagnosed with gynecological (GYN) cancers undergoing brachytherapy. METHODS: The skin doses were measured using TLDs attached in different locations on patients’ skin in pelvic regions (anterior, left, and right) for 20 patients, as well as on a phantom. In addition, the applicator surface dose was calculated with TLDs attached to the applicator. The measured doses were compared with TPS calculations to find TPS accuracy. For the phantom, different applicator shifts were applied to find the effect of applicator misplacement on the surface dose. RESULTS: The mean absolute dose differences between the TPS and TLDs results for anterior, left, and right points were 3.14±1.03, 6.25±1.88, and 6.20±1.97 %, respectively. The mean difference on the applicator surface was obtained 1.92±0.46 %. Applicator misplacements of 0.5, 2, and 4 cm (average of three locations) resulted in 9, 36, and 61%, dose errors respectively. CONCLUSIONS: The surface/skin differences between the calculations and measurements are higher in the left and right regions, which relate to the higher uncertainty of TPS dose calculation in these regions. Furthermore, applicator misplacements can result in high skin dose variations, therefore it can be an appropriate quality assurance method for future research.

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