SU-E-T-383: Evaluation of Deep Inspiration Breath-Hold Technique for Post-Mastectomy Proton Pencil Beam Scanning Therapy

Depauw, N; Patel, S; MacDonald, S; Lu, H

doi:10.1118/1.4924744

Title: SU-E-T-383: Evaluation of Deep Inspiration Breath-Hold Technique for Post-Mastectomy Proton Pencil Beam Scanning Therapy

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Abstract

Purpose: Deep inspiration breath-hold techniques (DIBH) have been shown to carry significant dosimetric advantages in conventional radiotherapy of left-sided breast cancer. The purpose of this study is to evaluate the use of DIBH techniques for post-mastectomy radiation therapy (PMRT) using proton pencil beam scanning (PBS). Method: Ten PMRT patients, with or without breast implant, underwent two helical CT scans: one with free breathing and the other with deep inspiration breath-hold. A prescription of 50.4 Gy(RBE) to the whole chest wall and lymphatics (axillary, supraclavicular, and intramammary nodes) was considered. PBS plans were generated for each patient’s CT scan using Astroid, an in-house treatment planning system, with the institution conventional clinical PMRT parameters; that is, using a single en-face field with a spot size varying from 8 mm to 14 mm as a function of energy. Similar optimization parameters were used in both plans in order to ensure appropriate comparison. Results: Regardless of the technique (free breathing or DIBH), the generated plans were well within clinical acceptability. DIBH allowed for higher target coverage with better sparing of the cardiac structures. The lung doses were also slightly improved. While the use of DIBH techniques might be of interest, it is technically challengingmore »« less

Authors:

Depauw, N; Patel, S; MacDonald, S; Lu, H ^[1]

Massachusetts General Hospital, Boston, MA (United States)

Publication Date:: Mon Jun 15 00:00:00 EDT 2015

OSTI Identifier:: 22548433

Resource Type:: Journal Article

Journal Name:: Medical Physics

Additional Journal Information:: Journal Volume: 42; Journal Issue: 6; Other Information: (c) 2015 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0094-2405

Country of Publication:: United States

Language:: English

Subject:: 60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; BEAMS; CHEST; COMPUTERIZED TOMOGRAPHY; DOSES; ENERGY DEPENDENCE; IMAGE PROCESSING; IMPLANTS; LUNGS; MAMMARY GLANDS; NEOPLASMS; OPTIMIZATION; PATIENTS; PLANNING; RADIOTHERAPY; RBE; RESPIRATION; SYNCHRONIZATION

Citation Formats


                    Depauw, N, Patel, S, MacDonald, S, and Lu, H. SU-E-T-383: Evaluation of Deep Inspiration Breath-Hold Technique for Post-Mastectomy Proton Pencil Beam Scanning Therapy.  United States: N. p., 2015. 
        Web.  doi:10.1118/1.4924744.

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                    Depauw, N, Patel, S, MacDonald, S, & Lu, H. SU-E-T-383: Evaluation of Deep Inspiration Breath-Hold Technique for Post-Mastectomy Proton Pencil Beam Scanning Therapy.  United States.  https://doi.org/10.1118/1.4924744

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                    Depauw, N, Patel, S, MacDonald, S, and Lu, H. 2015.  
        "SU-E-T-383: Evaluation of Deep Inspiration Breath-Hold Technique for Post-Mastectomy Proton Pencil Beam Scanning Therapy".  United States.  https://doi.org/10.1118/1.4924744.

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@article{osti_22548433,

  title        = {SU-E-T-383: Evaluation of Deep Inspiration Breath-Hold Technique for Post-Mastectomy Proton Pencil Beam Scanning Therapy},

  author       = {Depauw, N and Patel, S and MacDonald, S and Lu, H},

  abstractNote = {Purpose: Deep inspiration breath-hold techniques (DIBH) have been shown to carry significant dosimetric advantages in conventional radiotherapy of left-sided breast cancer. The purpose of this study is to evaluate the use of DIBH techniques for post-mastectomy radiation therapy (PMRT) using proton pencil beam scanning (PBS). Method: Ten PMRT patients, with or without breast implant, underwent two helical CT scans: one with free breathing and the other with deep inspiration breath-hold. A prescription of 50.4 Gy(RBE) to the whole chest wall and lymphatics (axillary, supraclavicular, and intramammary nodes) was considered. PBS plans were generated for each patient’s CT scan using Astroid, an in-house treatment planning system, with the institution conventional clinical PMRT parameters; that is, using a single en-face field with a spot size varying from 8 mm to 14 mm as a function of energy. Similar optimization parameters were used in both plans in order to ensure appropriate comparison. Results: Regardless of the technique (free breathing or DIBH), the generated plans were well within clinical acceptability. DIBH allowed for higher target coverage with better sparing of the cardiac structures. The lung doses were also slightly improved. While the use of DIBH techniques might be of interest, it is technically challenging as it would require a fast PBS delivery, as well as the synchronization of the beam delivery with a gating system, both of which are not currently available at the institution. Conclusion: DIBH techniques display some dosimetric advantages over free breathing treatment for PBS PMRT patients, which warrants further investigation. Plans will also be generated with smaller spot sizes (2.5 mm to 5.5 mm and 5 mm to 9 mm), corresponding to new generation machines, in order to further quantify the dosimetric advantages of DIBH as a function of spot size.},

  doi          = {10.1118/1.4924744},

  url          = {https://www.osti.gov/biblio/22548433},
  journal      = {Medical Physics},

  issn         = {0094-2405},

  number       = 6,

  volume       = 42,

  place        = {United States},

  year         = {Mon Jun 15 00:00:00 EDT 2015},

  month        = {Mon Jun 15 00:00:00 EDT 2015}

}

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