Home > Archives > IJSRST173629 IJSRST-Library

Breast Dosimetry: A Phantom study between tangential wedge fields and multiple open field-in-field 3D conformal forward planning

Authors(6) :-G. F. Acquah, P. O. Kyeremeh, C. O. Doudoo, P. Ahiagbenyo, C. Edusa, K. Beecham

Whole breast irradiation frequently leads to acute and long term toxicities which many studies [1-3] has shown to be associated with dose inhomogeneity (hot spots). A 3D conformal forward planning technique was studied to improve dose uniformity and potentially reduce toxicity for breast irradiation using segmented field-in field (FIF). A Rando Alderson female anthropomorphic phantom was CT scanned, planned with two conventional tangential wedge fields and then planned with the FIF technique. A 3D dose distribution for the tangential wedge fields (i.e. motorized wedges on the medial and lateral tangential) were obtained by selecting the best possible wedge combinations and photon energies, with the goal of reducing the hot spots in the breast below 110 percent of the prescribed dose. The 3D conformal forward plan employed using the multiple FIF was to achieve an optimal dose distribution and desired homogeneity through a complex manual fluence map optimization process. The FIF plan resulted in smaller “hot spots” far below 110% with a maximum dose of 102.8%, while maintaining greater coverage of the treatment volume. The dose homogeneity index was 1.00 of the treatment volume when using FIF as compared to 1.03 with standard wedges. The use of 3D forward planning with FIF technique for tangential breast radiotherapy is an efficient and effective method for achieving uniform dose throughout the breast. It is dosimetrically superior to the treatment technique that employs only wedges.
G. F. Acquah, P. O. Kyeremeh, C. O. Doudoo, P. Ahiagbenyo, C. Edusa, K. Beecham
Breast cancer, inhomogeneity, Conventional wedges, Field-in-field, Forward planning
  1. Harsolia A, Kestin L, Grills L et al. (2007) Intensity-modulated radiotherapy results in significant decrease in clinical toxicities compared with conventional wedge-based breast radiotherapy. Int J Radiat Oncol Biol Phys 68(5): 1375-80.
  2. Vicini F.A, Sharpe M, Kestin L et al. (2002) Optimizing breast cancer treatment efficacy with intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys 54(5):1336-44.
  3. Pignol J.P, Olivotto I, Rakovitch E, et al. (2008) A multicenter randomized trial of breast intensity-modulated radiation therapy to reduce acute radiation dermatitis. J Clin Oncol. 1; 26(13):2085-92.?
  4. Ferlay J, Soerjomataram I, Ervik M et al. (2013) GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 11, Lyon, France: International Agency for Research on Cancer.
  5. Brinton L, Figueroa J, Awuah B et al. (2014) Breast cancer in Sub-Saharan Africa: Opportunities for Prevention. Breast Cancer Res Treat 144(3): 467-478.
  6. Clarke M, Collins R, Darby S, Davies C, Elphinstone P, Evans E et al. (2005) Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomized trials. Lancet, 366: 2087?2106.
  7. Cuzick J, Stewart H, Rutqvist L, Houghton J, Edwards R, Redmond C, et al. (1994) Cause-specific mortality in long-term survivors of breast cancer who participated in trials of radiotherapy. J Clin Oncol, 12:447?53.
  8. ICRU 50. (1993) Prescribing, Recording and Reporting Photon Beam Therapy. International Commission on Radiation Units and Measurements, Bethesda, Maryland, USA.
  9. Li X.A, Tai A, Arthur D.W, Buchholz T.A et al. (2009) Variability of target and normal structure delineation for breast cancer radiotherapy: an RTOG Multi-Institutional and Multi observer Study. Int J Radiat Oncol Biol Phys. 2009; 73: 944?951. DOI: 10.1016/j.ijrobp.10.034.
Publication Details
  Published in : Volume 3 | Issue 6 | July-August 2017
  Date of Publication : 2017-08-31
License:  This work is licensed under a Creative Commons Attribution 4.0 International License.
Page(s) : 196-200
Manuscript Number : IJSRST173629
Publisher : Technoscience Academy
PRINT ISSN : 2395-6011
ONLINE ISSN : 2395-602X
Cite This Article :
G. F. Acquah, P. O. Kyeremeh, C. O. Doudoo, P. Ahiagbenyo, C. Edusa, K. Beecham, "Breast Dosimetry: A Phantom study between tangential wedge fields and multiple open field-in-field 3D conformal forward planning", International Journal of Scientific Research in Science and Technology(IJSRST), Print ISSN : 2395-6011, Online ISSN : 2395-602X, Volume 3, Issue 6, pp.196-200, July-August-2017
URL : http://ijsrst.com/IJSRST173629