SU-E-T-79: A Study of the Effect of Clinical Tumor Volume Displacement On the Dosage of Post Modified Radical Mastectomy Intensity-Modulated Radiation Therapy Plans for Left-Sided Breast Cancer

2015 ◽  
Vol 42 (6Part13) ◽  
pp. 3349-3349
Author(s):  
W Zhang ◽  
C Ma ◽  
D Li ◽  
F Wu
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Tumor Volume ◽  
Intensity Modulated Radiation Therapy ◽  
Radical Mastectomy ◽  
Modified Radical Mastectomy ◽  
Intensity Modulated ◽  
Clinical Tumor Volume

scholarly journals Dosimetric effects of supine immobilization devices on the skin in intensity-modulated radiation therapy for breast cancer: a retrospective study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ran Lv ◽  
Guangyi Yang ◽  
Yongzhi Huang ◽  
Yanhong Wang
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Retrospective Study ◽  
Intensity Modulated Radiation Therapy ◽  
Radical Mastectomy ◽  
Planning System ◽  
Treatment Planning System ◽  
Skin Dose ◽  
Intensity Modulated ◽  
Left And Right

Abstract Background The dose perturbation effect of immobilization devices is often overlooked in intensity-modulated radiation therapy (IMRT) for breast cancer (BC). This retrospective study assessed the dosimetric effects of supine immobilization devices on the skin using a commercial treatment planning system. Methods Forty women with BC were divided into four groups according to the type of primary surgery: groups A and B included patients with left and right BC, respectively, who received 50 Gy radiotherapy in 25 fractions after radical mastectomy, while groups C and D included patients with left and right BC, respectively, who received breast-conservation surgery (BCS) and 40.05 Gy in 15 fractions as well as a tumor bed simultaneous integrated boost to 45 Gy. A 0.2-cm thick skin contour and two sets of body contours were outlined for each patient. Dose calculations were conducted for the two sets of contours using the same plan. The dose differences were assessed by comparing the dose-volume histogram parameter results and by plan subtraction. Results The supine immobilization devices for BC resulted in significantly increased skin doses, which may ultimately lead to skin toxicity. The mean dose increased by approximately 0.5 and 0.45 Gy in groups A and B after radical mastectomy and by 2.7 and 3.25 Gy in groups C and D after BCS; in groups A–D, the percentages of total normal skin volume receiving equal to or greater than 5 Gy (V5) increased by 0.54, 1.15, 2.67, and 1.94%, respectively, while the V10 increased by 1.27, 1.83, 1.36, and 2.88%; the V20 by 0.85, 1.87, 2.76, and 4.86%; the V30 by 1.3, 1.24, 10.58, and 11.91%; and the V40 by 1.29, 0.65, 10, and 10.51%. The dose encompassing the planning target volume and other organs at risk, showed little distinction between IMRT plans without and with consideration of immobilization devices. Conclusions The supine immobilization devices significantly increased the dose to the skin, especially for patients with BCS. Thus, immobilization devices should be included in the external contour to account for dose attenuation and skin dose increment. Trial registration This study does not report on interventions in human health care.

Dosimetric Effects on skin of supine Immobilization Device in Intensity Modulated Radiation Therapy for breast cancer: a retrospective study

2020 ◽  
Author(s):  
Ran Lv ◽  
Guangyi Yang ◽  
Yongzhi Huang ◽  
Yanhong Wang
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Breast Conservation ◽  
Intensity Modulated Radiation Therapy ◽  
Radical Mastectomy ◽  
Skin Dose ◽  
Left Group ◽  
Intensity Modulated ◽  
Group A ◽  
Left And Right

Abstract BackgroundBreast immobilization devices are commonly used in supine breast radiotherapy while the dose perturbation effect is often overlooked in Intensity Modulated Radiation Therapy for breast cancer (BC). This study is to assess the dosimetric effect of supine immobilization devices on skin with a commercial treatment planning system.Methods40 women with BC were divided into four groups according to the type of primary surgery, group A and B corresponding to patients with left and right BC after radical mastectomy, received a radiotherapy of 50 Gy in 25 fractions, group C and D corresponding to patients with left and right BC after breast-conservation surgery, received a prescription of 40.05 Gy in15 fractions and tumor bed simultaneous integrated boost to 45 Gy. A 0.2 cm thick skin contour and two sets of body contours were outlined for each patient. Dose calculations were conducted for the two sets of contours using the same plan, the dose difference was assessed by comparing the dose-volume histogram parameter results and by plan subtraction.ResultsThe supine immobilization devices for BC caused a significantly increase in the skin dose which may finally lead to skin toxicity. The mean dose increased by approximately 0.5 Gy and 0.45 Gy in left (group A) and right (group B) BC after radical mastectomy, 2.7 Gy and 3.25 Gy in left (group C) and right (group D) BC after BCS; corresponding to group A, B, C, D, the V10 of skin increased1.27%,1.83%, 1.36%, 2.88% ; the V20 of skin increased 0.85%, 1.87%, 2.76%, 4.86%; the V30 of skin increased 1.3%, 1.24%, 10.58%, 11.91%; the V40 of skin increased 1.29%, 0.65%, 10%, 10.51%. The dose encompassing of planning target volume, as well as the HI and CI, showed little distinction between plan- and plan+.ConclusionThe supine immobilization devices significantly increased the dose of skin, especially for patients with BCS. The immobilization devices should be included in the external contour to account for the dose attenuation and skin dose increment.Trial registrationThis is a retrospectively study and it has no intervention on human health care, so this study was not registered.

scholarly journals Systematic Quantitative Evaluation of Plan-IQ for Intensity-Modulated Radiation Therapy After Modified Radical Mastectomy

2021 ◽  
Author(s):  
Kunzhi Chen ◽  
Zhuangzhuang Zheng ◽  
Lijuan Ding ◽  
Na Tao ◽  
Libo Wang ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Quantitative Evaluation ◽  
Organs At Risk ◽  
Intensity Modulated Radiation Therapy ◽  
Radical Mastectomy ◽  
Target Volume ◽  
Modified Radical Mastectomy ◽  
Planning Strategy ◽  
Intensity Modulated ◽  
The Individual

Abstract Background and purpose: A systematic quantitative evaluation of the quality change of intensity-modulated radiation therapy (IMRT) using the Plan-IQ feasibility tool was performed for modified radical mastectomy.Materials and methods: We selected 50 patients with breast cancer treated with IMRT. All patients received the same dose in the planning target volume (PTV). Two plans were designed for each patient: the clinically accepted normal plan group (NP group) and the repeat plan group (RP group). An automated planning strategy was generated using a Plan-IQ feasibility dose volume histogram (FDVH) in RP group. These plans were assessed according to the dosimetry parameters. A detailed scoring strategy was based on the RTOG9804 report and 2018 National Comprehensive Cancer Network guidelines, combined with clinical experience.Results: PTV coverage in both groups was achieved at 100% of the prescribed dose. Except for the thyroid coverage, the dose limit of organs at risk (OAR) in RP group was significantly better than that in NP group. In the scoring analysis, the total score of RP group decreased compared to that of NP group (P < 0.05), and the individual scores of PTV and OAR significantly changed. PTV score in RP group decreased (P < 0.01); however, OAR score improved (P < 0.01).Conclusions: The Plan-IQ FDVH was useful for evaluating a class solution for IMRT planning. Plan-IQ can automatically help physicians design the best OAR protection plan, which sacrifices part of PTV, while still meeting clinical requirements.

Correlation Between Toxicity and Dosimetric Parameters in Patients Treated with Adjuvant Intensity-Modulated Radiation Therapy for Breast Cancer: The Results of a Prospective Study.

2020 ◽  
Author(s):  
David Pasquier ◽  
Benoit Bataille ◽  
Florence Le Tinier ◽  
Raoudha Bennadji ◽  
Hélène Langin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Late Onset ◽  
Univariate Analysis ◽  
Intensity Modulated Radiation Therapy ◽  
Conservative Surgery ◽  
High Dose ◽  
Total Mastectomy ◽  
Intensity Modulated ◽  
A Prospective Study

Abstract Background. In the treatment of breast cancer, intensity-modulated radiation therapy (IMRT) reportedly reduces the high-dose irradiation of at-risk organs and decreases the frequency of adverse events (AEs). Comparisons with conventional radiotherapy have shown that IMRT is associated with lower frequencies of acute and late-onset AEs. Here, we extended a prospective, observational, single-center study of the safety of IMRT to a second investigating center. Methods. Patients scheduled for adjuvant IMRT after partial or total mastectomy were given a dose of 50 Gy (25 fractions of 2 Gy over five weeks), with a simultaneous integrated boost in patients having undergone conservative surgery. Results. 300 patients were included in the study, and 288 were analyzed. The median follow-up period was 2.1 years. Most AEs were mild. The most common AEs were skin-related - mainly radiodermatitis (in 266 patients (92.4%)) and hyperpigmentation (in 178 (61.8%)). Smoking (odds ratio) [95%CI] = 2.10 [1.14–3.87]; p = 0.017), no prior chemotherapy (0.52 [0.27–0.98]; p = 0.044), and D98% for subclavicular skin (1.030 [1.001–1.061]; p = 0.045) were associated with grade ≥ 2 acute AEs. In a univariate analysis, the mean dose, (p < 0.0001), D2% (p < 0.0001), D50% (p = 0.037), D95% (p = 0.0005), D98% (p = 0.0007), V30Gy (p < 0.0001), and V45Gy (p = 0.0001) were significantly associated with grade ≥ 1 acute esophageal AEs. In a multivariate analysis, D95% for the skin (p < 0.001), D98% for the subclavicular skin and low D95% for the internal mammary lymph nodes were associated with grade ≥ 1 medium-term AEs. Conclusions. The safety profile of adjuvant IMRT after partial or total mastectomy is influenced by dosimetric parameters. Trial registration: ClinicalTrials.gov NCT02281149

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