Investigation of Accelerated Partial Breast Patient Alignment and Treatment With Helical Tomotherapy Unit

Journal Article · Sat Mar 15 04:00:00 EDT 2008 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2007.11.019· OSTI ID:21039853

Buchholz, Daniel J; Burch, Doug R. C.; Burkavage, Rob C; Limaye, Arti U; Meeks, Sanford L; Kupelian, Patrick A ^[1]; Ruchala, Kenneth J; Haimerl, Jason; Henderson, Doug ^[2]; Olivera, Gustavo H ^[2]

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1. Department of Radiation Oncology, M. D. Anderson Cancer Center Orlando, Orlando, FL (United States)
2. TomoTherapy, Incorporated, Madison, WI (United States)

Purpose: To determine the precision of megavoltage computed tomography (MVCT)-based alignment of the seroma cavity for patients undergoing partial breast irradiation; and to determine whether accelerated partial breast irradiation (APBI) plans can be generated for TomoTherapy deliveries that meet the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-39/Radiation Therapy Oncology Group (RTOG) 0413 protocol guidelines for target coverage and normal tissue dose limitations. Methods and Materials: We obtained 50 MVCT images from 10 patients. An interuser study was designed to assess the alignment precision. Using a standard helical and a fixed beam prototype ('topotherapy') optimizer, two APBI plans for each patient were developed. Results: The precision of the MVCT-based seroma cavity alignment was better than 2 mm if averaged over the patient population. Both treatment techniques could be used to generate acceptable APBI plans for patients that fulfilled the recommended NSABP B-39/RTOG-0413 selection criteria. For plans of comparable treatment time, the conformation of the prescription dose to the target was greater for helical deliveries, while the ipsilateral lung dose was significantly reduced for the topotherapy plans. Conclusions: The inherent volumetric imaging capabilities of a TomoTherapy Hi-Art unit allow for alignment of patients undergoing partial breast irradiation that is determined from the visibility of the seroma cavity on the MVCT image. The precision of the MVCT-based alignment was better than 2 mm ({+-} standard deviation) when averaged over the patient population. Using the NSABP B-39/RTOG-0413 guidelines, acceptable APBI treatment plans can be generated using helical- or topotherapy-based delivery techniques.

• OSTI ID: 21039853
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 70; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ACCURACY
ALIGNMENT
COMPUTERIZED TOMOGRAPHY
CT-GUIDED RADIOTHERAPY
IMAGES
IRRADIATION
LUNGS
MAMMARY GLANDS
PATIENTS
RADIATION DOSES
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