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Strahlenther Onkol. 2009 Sep;185(9):574-81. doi: 10.1007/s00066-009-1979-7. Epub 2009 Sep 12.

Surface dose in the treatment of breast cancer with helical tomotherapy.

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  • 1Department of Radiation Oncology, University of Heidelberg, Im Neuenheimer Feld 400, Heidelberg, Germany.

Abstract

PURPOSE:

Investigation of the effects of breathing motion- and misregistration-induced errors on the superficial dose in the treatment of breast cancer using helical tomotherapy (HT).

MATERIAL AND METHODS:

Surface dose measurements were performed with thermoluminescence dosimetry (TLD). Two treatment plans with different planning target volume (PTV) definitions of the left breast were used: PTVskin had its ventral border exactly on skin level, while PTVair included also a 10-mm extension ventral to the PTVskin. With a thoracic static phantom, misregistration errors in an HT were simulated. A dynamic phantom was used to simulate a breathing patient during HT. Surface doses of breast cancer patients were measured both for an HT (179 points) and a conventional three-dimensional conformal treatment (70 points).

RESULTS:

In the static phantom misregistration setup, dose deviations of -31.9% for PTVskin to +35.4% for PTVair could be observed. The dynamic phantom measurements resulted in surface dose deviations from those in a static position between 0.8% and 3.8% without a significant difference for the PTV definitions. The measured surface doses on patients averaged (mean +/- standard deviation) 1.65 +/- 0.13 Gy for the HT and 1.42 +/- 0.11 Gy for the three-dimensional conformal treatment.

CONCLUSION:

HT enables a homogeneous and reproducible surface dose with small dose deviations in the treatment of breast cancer. HT is a feasible method to treat breast cancer under free shallow breathing of the patient using a treatment plan with a ventral PTV border on the skin level.

PMID:
19756423
[PubMed - indexed for MEDLINE]
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