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Title: Body radiation exposure in breast cancer radiotherapy: Impact of breast IMRT and virtual wedge compensation techniques

Abstract

Purpose: Recent reports demonstrate a dramatically increased rate of secondary leukemia for breast cancer patients receiving adjuvant high-dose anthracycline and radiotherapy, and that radiation is an independent factor for the development of leukemia. This study aimed to evaluate the radiation body exposure during breast radiotherapy and to characterize the factors associated with an increased exposure. Patients and Methods: In a prospective cohort of 120 women, radiation measurements were taken from four sites on the body at the time of adjuvant breast radiotherapy. Multiple regression analysis was performed to analyze patient and treatment factors associated with the amount of scattered radiation. Results: For standard 50 Gy breast radiotherapy, the minimal dose received by abdominal organs is on average 0.45 Gy, ranging from 0.06 to 1.55 Gy. The use of physical wedges as a compensation technique was the most significant factor associated with increased scattered dose (p < 0.001), resulting in approximately three times more exposure compared with breast intensity-modulated radiation therapy (IMRT) and dynamic wedge. Conclusions: The amount of radiation that is scattered to a patient's body is consistent with exposure reported to be associated with excess of leukemia. In accordance with the As Low As Reasonably Achievable (ALARA) principle, wemore » recommend using breast IMRT or virtual wedging for the radiotherapy of breast cancer receiving high-dose anthracycline chemotherapy.« less

Authors:
 [1];  [2];  [1];  [1];  [1];  [3];  [4]
  1. Department of Radiation Oncology, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario (Canada)
  2. Department of Radiation Oncology, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario (Canada). E-mail: Jean-Philippe.Pignol@sw.ca
  3. Department of Medical Physics, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario (Canada)
  4. Department of Medical Oncology, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario (Canada)
Publication Date:
OSTI Identifier:
20793455
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 65; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2005.11.023; PII: S0360-3016(05)02977-9; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ALARA; CHEMOTHERAPY; LEUKEMIA; MAMMARY GLANDS; PATIENTS; RADIATION DOSES; RADIOTHERAPY; SAFETY STANDARDS; WOMEN

Citation Formats

Woo, Tony, Pignol, Jean-Philippe, Rakovitch, Eileen, Vu, Toni, Hicks, Deanna, O'Brien, Peter, and Pritchard, Kathleen. Body radiation exposure in breast cancer radiotherapy: Impact of breast IMRT and virtual wedge compensation techniques. United States: N. p., 2006. Web. doi:10.1016/J.IJROBP.2005.1.
Woo, Tony, Pignol, Jean-Philippe, Rakovitch, Eileen, Vu, Toni, Hicks, Deanna, O'Brien, Peter, & Pritchard, Kathleen. Body radiation exposure in breast cancer radiotherapy: Impact of breast IMRT and virtual wedge compensation techniques. United States. doi:10.1016/J.IJROBP.2005.1.
Woo, Tony, Pignol, Jean-Philippe, Rakovitch, Eileen, Vu, Toni, Hicks, Deanna, O'Brien, Peter, and Pritchard, Kathleen. Mon . "Body radiation exposure in breast cancer radiotherapy: Impact of breast IMRT and virtual wedge compensation techniques". United States. doi:10.1016/J.IJROBP.2005.1.
@article{osti_20793455,
title = {Body radiation exposure in breast cancer radiotherapy: Impact of breast IMRT and virtual wedge compensation techniques},
author = {Woo, Tony and Pignol, Jean-Philippe and Rakovitch, Eileen and Vu, Toni and Hicks, Deanna and O'Brien, Peter and Pritchard, Kathleen},
abstractNote = {Purpose: Recent reports demonstrate a dramatically increased rate of secondary leukemia for breast cancer patients receiving adjuvant high-dose anthracycline and radiotherapy, and that radiation is an independent factor for the development of leukemia. This study aimed to evaluate the radiation body exposure during breast radiotherapy and to characterize the factors associated with an increased exposure. Patients and Methods: In a prospective cohort of 120 women, radiation measurements were taken from four sites on the body at the time of adjuvant breast radiotherapy. Multiple regression analysis was performed to analyze patient and treatment factors associated with the amount of scattered radiation. Results: For standard 50 Gy breast radiotherapy, the minimal dose received by abdominal organs is on average 0.45 Gy, ranging from 0.06 to 1.55 Gy. The use of physical wedges as a compensation technique was the most significant factor associated with increased scattered dose (p < 0.001), resulting in approximately three times more exposure compared with breast intensity-modulated radiation therapy (IMRT) and dynamic wedge. Conclusions: The amount of radiation that is scattered to a patient's body is consistent with exposure reported to be associated with excess of leukemia. In accordance with the As Low As Reasonably Achievable (ALARA) principle, we recommend using breast IMRT or virtual wedging for the radiotherapy of breast cancer receiving high-dose anthracycline chemotherapy.},
doi = {10.1016/J.IJROBP.2005.1},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 65,
place = {United States},
year = {Mon May 01 00:00:00 EDT 2006},
month = {Mon May 01 00:00:00 EDT 2006}
}