Journal Article10.1088/0031-9155/56/23/005
Dosimetric evaluation of breast radiotherapy in a dynamic phantom.
TL;DR: It is demonstrated that the effect of respiratory motion is negligible for all planning techniques except in occasional instances of large motion.
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Abstract: This phantom study quantifies changes in delivered dose due to respiratory motion for four breast radiotherapy planning techniques: three intensity-modulated techniques (forward-planned, surface-compensated and hybrid intensity-modulated radiation therapy (IMRT)); using a combination of open fields and inverse planned IMRT) and a 2D conventional technique. The plans were created on CT images of a wax breast phantom with a cork lung insert, and dose distributions were measured using films inserted through slits in the axial and sagittal planes. Films were irradiated according to each plan under a static (modeling breathhold) and three dynamic conditions—isocenter set at mid-respiratory cycle with motion amplitudes of 1 and 2 cm and at end-cycle with 2 cm motion amplitude (modeling end-exhale). Differences between static and moving deliveries were most pronounced for the more complex planning techniques with hot spots of up to 107% appearing in the anterior portion of all three IMRT plans at the largest motion at the end-exhale set-up. The delivered dose to the moving phantom was within 5% of that to the static phantom for all cases, while measurement accuracy was ±3%. The homogeneity index was significantly decreased only for the 2 cm motion end-exhale set-up; however, this same motion increased the equivalent uniform dose because of improved posterior breast coverage. Overall, the study demonstrates that the effect of respiratory motion is negligible for all planning techniques except in occasional instances of large motion.
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Citations
External respiratory motion analysis and statistics for patients and volunteers
TL;DR: This database compilation can be used as a resource for expected motion when using external surrogates in radiotherapy applications and found that peak‐to‐peak amplitude was the most variable parameter for both intra‐ and interfraction motion.
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Accounting for respiratory motion in partial breast intensity modulated radiotherapy during treatment planning: a new patient selection metric.
TL;DR: The DEV-to-PTV ratio is proposed as a delineating metric for identifying patient plans that will be more degraded by respiratory motion and may be a more robust metric than ipsilateral breast volume because the seroma volume is contoured more consistently between physicians and clinics.
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A two-point scheme for optimal breast IMRT treatment planning
TL;DR: Compared with 3D CRT plans composed of unblocked and field‐in‐field beams, the optimal plans demonstrated comparable or better dose uniformity, homogeneity, and conformity to the target, especially at beam junction when supraclavicular nodes are involved.
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When is respiratory management necessary for partial breast intensity modulated radiotherapy: a respiratory amplitude escalation treatment planning study.
TL;DR: If respiratory amplitude is greater than 10 mm, respiratory management or alternative radiotherapy should be considered due to an increase in the hotspot in the ipsilateral breast and a decrease in dose homogeneity.
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Tridimensional dose evaluation of the respiratory motion influence on breast radiotherapy treatments using conformal radiotherapy, forward IMRT, and inverse IMRT planning techniques.
Jéssica Caroline Lizar,Karina Cristina Volpato,Fernanda Calixto Brandão,Flávio da Silva Guimarães,Gustavo Viani Arruda,Juliana Fernandes Pavoni +5 more
TL;DR: In this paper, the authors evaluated the respiratory motion influence on tridimensional (3D) dose delivery to breast-shaped phantoms using conformal radiotherapy, field-in-field (FiF), and IMRT planning techniques.
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