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Breast Radiotherapy with Mixed Energy Photons; a Model for Optimal Beam Weighting
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 Title & Authors
Breast Radiotherapy with Mixed Energy Photons; a Model for Optimal Beam Weighting
Birgani, Mohammadjavad Tahmasebi; Fatahiasl, Jafar; Hosseini, Seyed Mohammad; Bagheri, Ali; Behrooz, Mohammad Ali; Zabiehzadeh, Mansour; meskani, Reza; Gomari, Maryam Talaei;
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 Abstract
Utilization of high energy photons (>10MV) with an optimal weight using a mixed energy technique is a practical way to generate a homogenous dose distribution while maintaining adequate target coverage in intact breast radiotherapy. This study represents a model for estimation of this optimal weight for day to day clinical usage. For this purpose, treatment planning computed tomography scans of thirty-three consecutive early stage breast cancer patients following breast conservation surgery were analyzed. After delineation of the breast clinical target volume (CTV) and placing opposed wedge paired isocenteric tangential portals, dosimeteric calculations were conducted and dose volume histograms (DVHs) were generated, first with pure 6MV photons and then these calculations were repeated ten times with incorporating 18MV photons (ten percent increase in weight per step) in each individual patient. For each calculation two indexes including maximum dose in the breast CTV () and the volume of CTV which covered with 95% Isodose line () were measured according to the DVH data and then normalized values were plotted in a graph. The optimal weight of 18MV photons was defined as the intersection point of and graphs. For creating a model to predict this optimal weight multiple linear regression analysis was used based on some of the breast and tangential field parameters. The best fitting model for prediction of 18MV photons optimal weight in breast radiotherapy using mixed energy technique, incorporated chest wall separation plus central lung distance (Adjusted R2
 Keywords
Breast neoplasms;radiotherapy;treatment planning;high energy photons;toxicity;
 Language
English
 Cited by
 References
1.
Baird CT, Starkschall G, Liu HH, et al (2001). Verification of tangential breast treatment dose calculations in a commercial 3D treatment planning system. J Applied Clin Med Physics, 2, 73-84. crossref(new window)

2.
Bornstein BA, Cheng CW, Rhodes LM, et al (1990). Can simulation measurements be used to predict the irradiated lung volume in the tangential fields in patients treated for breast cancer? Int J Radiat Oncol Biol Phys, 18, 181-7. crossref(new window)

3.
Buchholz TA, Gurgoze E, Bice WS, et al (1997). Dosimetric analysis of intact breast irradiation in off-axis planes. Int J Radiat Oncol Biol Phys, 39, 261-7.

4.
Carruthers LJ, Redpath AT, Kunkler IH (1999). The use of compensators to optimise the three dimensional dose distribution in radiotherapy of the intact breast. Radiother Oncol, 50, 291-300. crossref(new window)

5.
Das IJ, Cheng CW, Fein DA, et al (1997). Patterns of dose variability in radiation prescription of breast cancer. Radiother Oncol, 44, 83-9. crossref(new window)

6.
Edward C. Halperin DEW, Carlos A. Perez, Luther W. Brady 2013. Principles and practice of radiation oncology, Philadelphia, LWW.

7.
Ellen MM, Hogstrom KR, Miller LA, et al (1999). A comparison of 18-MV and 6-MV treatment plans using 3D dose calculation with and without heterogeneity correction. Medical Dosimetry, 24, 287-94. crossref(new window)

8.
Faiz M. Khan JPG 2014. Khan's The Physics of Radiation Therapy, Philadelphia, LWW.

9.
Grau C, Defourny N, Malicki J, et al (2014). Radiotherapy equipment and departments in the European countries: final results from the ESTRO-HERO survey. Radiother Oncol, 112, 155-64. crossref(new window)

10.
Haffty BG, Buchholz TA, McCormick B (2008). Should intensity-modulated radiation therapy be the standard of care in the conservatively managed breast cancer patient? J Clin Oncol, 26, 2072-4. crossref(new window)

11.
Lief EP, Hunt MA, Hong LX, et al (2007). Radiation therapy of large intact breasts using a beam spoiler or photons with mixed energies. Med Dosim, 32, 246-53. crossref(new window)

12.
Morganti AG, Cilla S, de Gaetano A, et al (2011). Forward planned intensity modulated radiotherapy (IMRT) for whole breast postoperative radiotherapy. Is it useful? When? J Applied Clin Med Physics, 12.

13.
Pignol JP, Olivotto I, Rakovitch E, et al (2008). A multicenter randomized trial of breast intensity-modulated radiation therapy to reduce acute radiation dermatitis. J Clin Oncol, 26, 2085-92. crossref(new window)

14.
Smith BD, Pan IW, Shih YCT, et al (2011). Adoption of Intensity-Modulated Radiation Therapy for Breast Cancer in the United States. JNCI Journal of the National Cancer Institute, 103, 798-809. crossref(new window)

15.
Stillie AL, Kron T, Herschtal A, et al (2011). Does inverse planned intensity modulated radiation therapy have a role in the treatment of patients with left sided breast cancer? J Med Imaging Radiation Oncol, 55, 311-9. crossref(new window)

16.
Taylor ME, Perez CA, Halverson KJ, et al (1995). Factors influencing cosmetic results after conservation therapy for breast cancer. Intern J Radiation Oncol* Biol* Physics, 31, 753-64.