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Title: Simplified field-in-field technique for a large-scale implementation in breast radiation treatment

Abstract

We wanted to evaluate a simplified 'field-in-field' technique (SFF) that was implemented in our department of Radiation Oncology for breast treatment. This study evaluated 15 consecutive patients treated with a simplified field in field technique after breast-conserving surgery for early-stage breast cancer. Radiotherapy consisted of whole-breast irradiation to the total dose of 50 Gy in 25 fractions, and a boost of 16 Gy in 8 fractions to the tumor bed. We compared dosimetric outcomes of SFF to state-of-the-art electronic surface compensation (ESC) with dynamic leaves. An analysis of early skin toxicity of a population of 15 patients was performed. The median volume receiving at least 95% of the prescribed dose was 763 mL (range, 347-1472) for SFF vs. 779 mL (range, 349-1494) for ESC. The median residual 107% isodose was 0.1 mL (range, 0-63) for SFF and 1.9 mL (range, 0-57) for ESC. Monitor units were on average 25% higher in ESC plans compared with SFF. No patient treated with SFF had acute side effects superior to grade 1-NCI scale. SFF created homogenous 3D dose distributions equivalent to electronic surface compensation with dynamic leaves. It allowed the integration of a forward planned concomitant tumor bed boost as an additional multileafmore » collimator subfield of the tangential fields. Compared with electronic surface compensation with dynamic leaves, shorter treatment times allowed better radiation protection to the patient. Low-grade acute toxicity evaluated weekly during treatment and 2 months after treatment completion justified the pursuit of this technique for all breast patients in our department.« less

Authors:
 [1];  [2];  [3]; ; ;  [3]
  1. Department of Medical Physics, Institut Curie, Paris (France)
  2. (France)
  3. Department of Radiation Oncology, Institut Curie, Paris (France)
Publication Date:
OSTI Identifier:
22130392
Resource Type:
Journal Article
Journal Name:
Medical Dosimetry
Additional Journal Information:
Journal Volume: 37; Journal Issue: 2; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0958-3947
Country of Publication:
United States
Language:
English
Subject:
61 RADIATION PROTECTION AND DOSIMETRY; COLLIMATORS; DOSIMETRY; IMPLEMENTATION; IRRADIATION; MAMMARY GLANDS; NEOPLASMS; PATIENTS; RADIATION DOSE DISTRIBUTIONS; RADIATION DOSES; RADIATION MONITORS; RADIATION PROTECTION; RADIOTHERAPY; SIDE EFFECTS; SKIN; SURGERY; TOXICITY

Citation Formats

Fournier-Bidoz, Nathalie, Department of Radiation Oncology, Institut Curie, Paris, Kirova, Youlia M., E-mail: youlia.kirova@curie.net, Campana, Francois, Dendale, Remi, and Fourquet, Alain. Simplified field-in-field technique for a large-scale implementation in breast radiation treatment. United States: N. p., 2012. Web. doi:10.1016/J.MEDDOS.2011.03.002.
Fournier-Bidoz, Nathalie, Department of Radiation Oncology, Institut Curie, Paris, Kirova, Youlia M., E-mail: youlia.kirova@curie.net, Campana, Francois, Dendale, Remi, & Fourquet, Alain. Simplified field-in-field technique for a large-scale implementation in breast radiation treatment. United States. doi:10.1016/J.MEDDOS.2011.03.002.
Fournier-Bidoz, Nathalie, Department of Radiation Oncology, Institut Curie, Paris, Kirova, Youlia M., E-mail: youlia.kirova@curie.net, Campana, Francois, Dendale, Remi, and Fourquet, Alain. Sun . "Simplified field-in-field technique for a large-scale implementation in breast radiation treatment". United States. doi:10.1016/J.MEDDOS.2011.03.002.
@article{osti_22130392,
title = {Simplified field-in-field technique for a large-scale implementation in breast radiation treatment},
author = {Fournier-Bidoz, Nathalie and Department of Radiation Oncology, Institut Curie, Paris and Kirova, Youlia M., E-mail: youlia.kirova@curie.net and Campana, Francois and Dendale, Remi and Fourquet, Alain},
abstractNote = {We wanted to evaluate a simplified 'field-in-field' technique (SFF) that was implemented in our department of Radiation Oncology for breast treatment. This study evaluated 15 consecutive patients treated with a simplified field in field technique after breast-conserving surgery for early-stage breast cancer. Radiotherapy consisted of whole-breast irradiation to the total dose of 50 Gy in 25 fractions, and a boost of 16 Gy in 8 fractions to the tumor bed. We compared dosimetric outcomes of SFF to state-of-the-art electronic surface compensation (ESC) with dynamic leaves. An analysis of early skin toxicity of a population of 15 patients was performed. The median volume receiving at least 95% of the prescribed dose was 763 mL (range, 347-1472) for SFF vs. 779 mL (range, 349-1494) for ESC. The median residual 107% isodose was 0.1 mL (range, 0-63) for SFF and 1.9 mL (range, 0-57) for ESC. Monitor units were on average 25% higher in ESC plans compared with SFF. No patient treated with SFF had acute side effects superior to grade 1-NCI scale. SFF created homogenous 3D dose distributions equivalent to electronic surface compensation with dynamic leaves. It allowed the integration of a forward planned concomitant tumor bed boost as an additional multileaf collimator subfield of the tangential fields. Compared with electronic surface compensation with dynamic leaves, shorter treatment times allowed better radiation protection to the patient. Low-grade acute toxicity evaluated weekly during treatment and 2 months after treatment completion justified the pursuit of this technique for all breast patients in our department.},
doi = {10.1016/J.MEDDOS.2011.03.002},
journal = {Medical Dosimetry},
issn = {0958-3947},
number = 2,
volume = 37,
place = {United States},
year = {2012},
month = {7}
}