PMID- 21641066
OWN - NLM
STAT- MEDLINE
DCOM- 20111229
LR  - 20110902
IS  - 1879-0887 (Electronic)
IS  - 0167-8140 (Linking)
VI  - 100
IP  - 2
DP  - 2011 Aug
TI  - Radiation therapy of post-mastectomy patients with positive nodes using fixed 
      beam tomotherapy.
PG  - 247-52
LID - 10.1016/j.radonc.2011.05.004 [doi]
AB  - PURPOSES: To develop an optimized dosimetric class solution for post-mastectomy 
      irradiation for fixed beam tomotherapy (FBT). METHODS AND MATERIALS: CT 
      simulation scans from 10 post-mastectomy patients were used to generate plans 
      with planning target volumes (PTVs) that included the chest wall, axillary nodes 
      and supraclavical nodes using FBT and helical tomotherapy (HT) with 3D and IMRT 
      modes and the resultant dosimetry was compared to conventional IMRT. FBT IMRT 
      plans were analyzed with both 4 (4FBT) and 11-field (11FBT) plans. Important 
      organs at risk (OARs) included the heart, ipsilateral and contralateral lungs, 
      esophagus and contralateral breast. In all plans, the spinal cord and 
      contralateral lung were completely blocked while the heart and ipsilateral lung 
      were directionally blocked. Doses to the contralateral breast were minimized. 
      Each plan was evaluated for its delivery time, percentile volume of lung 
      receiving x Gy (V(x)) and dose received by x percent volume (D(x)). D(1) and D(5) 
      were used to measure the maximum dose to the OAR or PTV, D(95) and D(99) were 
      used to measure the minimal dose to the PTV. RESULTS: Compared to the 
      conventional IMRT technique, HT IMRT, 11FBT IMRT and 11FBT 3D significantly 
      reduced the D(1) of the heart in cases of left-sided tumors by 13%, 41% and 36%, 
      and the V(10) of ipsilateral lung in all cases by 26%, 49% and 46%, respectively. 
      A close to 90% reduction in the contralateral breast dose was also observed with 
      the 11FBT plans. Target dose homogeneity of 11FBT 3D plans is inferior to that of 
      the HT and conventional IMRT plans but the treatment delivery time, 7.59 min, was 
      significantly shorter by 3 min. 4FBT IMRT resulted in clinically unacceptable 
      heterogeneity with high dose regions in both the PTV and normal tissue. 
      CONCLUSIONS: A class solution based on an 11 beam configuration was established 
      to optimize the dosimetry of fixed beam tomotherapy planning for post-mastectomy 
      patients. The 11FBT plans were deliverable in clinically efficient treatment 
      times.
CI  - Copyright (c) 2011 Elsevier Ireland Ltd. All rights reserved.
FAU - Jones, Ryan
AU  - Jones R
AD  - Department of Radiation Oncology, University of Virginia, VA, USA.
FAU - Yang, Wensha
AU  - Yang W
FAU - Read, Paul
AU  - Read P
FAU - Sheng, Ke
AU  - Sheng K
LA  - eng
PT  - Journal Article
PL  - Ireland
TA  - Radiother Oncol
JT  - Radiotherapy and oncology : journal of the European Society for Therapeutic 
      Radiology and Oncology
JID - 8407192
SB  - IM
MH  - Breast Neoplasms/*radiotherapy/surgery
MH  - Combined Modality Therapy
MH  - Female
MH  - Humans
MH  - *Mastectomy
MH  - Organs at Risk
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted
MH  - Radiotherapy, Intensity-Modulated/instrumentation/*methods
MH  - Time Factors
EDAT- 2011/06/07 06:00
MHDA- 2011/12/30 06:00
CRDT- 2011/06/07 06:00
PHST- 2010/05/04 00:00 [received]
PHST- 2011/05/03 00:00 [revised]
PHST- 2011/05/04 00:00 [accepted]
PHST- 2011/06/07 06:00 [entrez]
PHST- 2011/06/07 06:00 [pubmed]
PHST- 2011/12/30 06:00 [medline]
AID - S0167-8140(11)00196-4 [pii]
AID - 10.1016/j.radonc.2011.05.004 [doi]
PST - ppublish
SO  - Radiother Oncol. 2011 Aug;100(2):247-52. doi: 10.1016/j.radonc.2011.05.004.