Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-28T02:19:10.652Z Has data issue: false hasContentIssue false
  • English
  • Français

Characterisation of 6MV and 10MV superficial build up dosimetry in tangential beam radiography

Published online by Cambridge University Press:  01 December 2007

Craig Lacey ,
Kirsti Gordon  and
Colin Nalder
Craig Lacey*
Affiliation:
Radiographer, Royal Marsden NHS Foundation Trust, Fulham Road, London,UK
Kirsti Gordon
Affiliation:
Senior Lecturer, School of Radiography, Kingston University, UK
Colin Nalder
Affiliation:
Physicist, Royal Marsden NHS Foundation Trust, Fulham Road, London, UK
*
Correspondence to: Craig Lacey, Radiographer, Royal Marsden NHS Foundation Trust, Fulham Road, UK. E-mail: craigylacey@aol.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction: Although tangential radiotherapy is one of the major treatments for breast cancer, little has been done to address the skin toxicity and general dose inhomogeneity experienced in patients with larger breasts that are treated with 6MV photons. From our understanding of radiation in tissue at depth, it is proposed that 10MV photons could have a clear role in such patients through improved dose distribution. However, a greater build up depth with 10MV could mean that this energy is unacceptable.

Aims: To quantify and characterise superficial build up dosimetry in tangential breast irradiation for 6MV and 10MV photons.

Methods: Using Thermoluminescent Dosimeters (TLD’S), a comparative study was carried out investigating dose at a range of superficial depths in a phantom irradiated by tangential fields. Each delivering 2Gy for 6MV and 10MV photons.

Results: There was a 0.10Gy difference in maximum dose over a depth of 10.8 mm between 6MV and 10MV photons, along with an average difference of dose at depth of 0.09Gy.

Conclusion: Evidence has been obtained that eliminates comprise to superficial tissue if 10MV photons are used. Furthermore, reinforcement towards a more homogenous dose distribution with 10MV photons has been established.

Keywords

breast cancerdosimetrysuperficial build uptangential beam radiographytoxicity6MV/10MV photons
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 6 , Issue 4 , December 2007 , pp. 229 - 241
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bomford, CK, Kunkler, IH. Walter and Miller’s Textbook of Radiotherapy. 6th edition. UK: Churchill Livingstone, 2003.Google Scholar
Tobias, JS, Vaidya, JS, Keshtgar, M, Douek, M, Metaxas, M, Stacey, C, Sainsbury, R, D'Souza, D, Baum, M.Breast conserving surgery with intra operative radiotherapy: the right approach for the 21st century? Clin Oncol 2005; 18:220–228.CrossRefGoogle Scholar
Coles, CE, Moody, AM, Wilson, CB, Burnet, NG. Reduction of radiotherapy induced late complications in early breast cancer: the role of intensity modulated radiotherapy and partial irradiation. Part 1—normal tissue complications. Clin Oncol 2005; 17:16–24.Google Scholar
Remouchamps, VM, Letts, N, Vicini, FA, Sharpe, MB, Kestin, LL, Chen, PY, Martinez, AA, Wong, JW.Initial clinical experience with moderate deep-inspiration breath hold using an active breathing control device in the treatment of patients with left-sided breast cancer using external beam radiation therapy. Int J Radiat Oncol Biol Phys 2003; 47:895–904.Google Scholar
Chao, KK, Vicini, FA, Wallace, M, Mitchell, C, Chen, P, Ghilezan, M, Gilbert, S, Kunzman, J, Benitez, P, Martinez, A.Analysis of treatment efficacy, cosmesis, and toxicity using the mammoSite breast brachytherapy catheter to deliver accelerated partial-breast irradiation: The william beaumont hospital experience. Int J Radiat Oncol Biol Phys 2007; 69:32–40.Google Scholar
Early Breast Cancer Trialists’ Collaborative Group. Favourable and unfavourable effects on long-term survival of radiotherapy for early breast cancer: an overview of the randomised trials. Lancet 2000; 69:1757–1770.Google Scholar
Porock, D, Kristjanson, L.Skin reactions during radiotherapy for breast cancer: the use and impact of topical agents and dressings. Eur J Cancer Care (Engl) 1999; 8:143–153.CrossRefGoogle ScholarPubMed
Winfield, EA, Deighton, A, Venables, K, Hoskin, PJ, Aird, EGA.Survey of UK breast radiotherapy techniques: background prior to the introduction of the quality assurance programme for the START (Standardization of Radiotherapy) trial in breast cancer. Clin Oncol 2002; 14:267–271.CrossRefGoogle Scholar
Winfield, EA, Deighton, A, Venables, K, Hoskin, PJ, Aird, EGA.Survey of tangential field planning and dose distribution in the UK: background to the introduction of the quality assurance programme for the START trial in early breast cancer. Br J Radiol 2003; 76:254–259.Google Scholar
Neal, AJ, Mayles, WP, Yarnold, JR. Invited review: tangential breast irradiation—rationale and methods for improving dosimetry. Br J Radiol 1994; 67:1149–1154.Google Scholar
Neal, AJ, Torr, M, Helyer, S, Yarnold, JR.Correlation of breast dose heterogeneity with breast size using 3D CT planning and dose-volume histograms. Radiat Oncol 1995; 34:210–218.Google Scholar
Kestin, LL, Sharpe, MB, Frazier, RC, et al. Intensity modulation to improve dose uniformity with tangential breast radiotherapy: initial clinical experience. Int J Radiat Oncol Biol Phys 2000; 48:1559–1568.CrossRefGoogle ScholarPubMed
Yarnold, J, Donovan, E, Bleackley, N, et al. Randomised trial of standard 2D radiotherapy (RT) versus 3D intensity modulated radiotherapy (IMRT) in patients prescribed breast radiotherapy. Clin Oncol 2002; 14:S40.Google Scholar
Yanold, J, Owen, JR, Ashorten, A, et al. Fractionation sensitivity of change in breast appearance after radiotherapy for early breast cancer: long-term results of a randomised trial. Clin Oncol 2002; 14:S44.Google Scholar
Donovan, EM, Bleackley, NJ, Evans, PM, Reise, SF, Yarnold, JR.Dose-position and dose-volume histogram analysis of standard wedged and intensity modulated treatments in breast radiotherapy. Br J Radiol 2002; 75:967–973.Google Scholar
Redpath, AT, Thwaites, DI, Rodger, A, AitkenMW, MW,Hardiman, PDJ.A Multidisciplinary approach to improving the quality of tangential chest wall and breast irradiation for carcinoma of the breast. Radiat Oncol 1992; 23:118–126.Google Scholar
Moody, AM, Mayles, WP, Bliss, JM, et al. The influence of breast size on late irradiation effects and association with radiotherapy dose inhomogeneity. Radiat Oncol 1994; 33: 106–112.Google Scholar
START Trial Management Group. Standardization of Breast Radiotherapy (START) trial. Clin Oncol 1999; 11:145–147.Google Scholar
Bartlink, H.Commentary on the paper ‘A preliminary report of intraoperative radiotherapy (IORT) in limited-stage breast cancers that are conservatively treated.’ A critical review of an innovative approach. Eur J Cancer 2001; 37:2143–2146.CrossRefGoogle Scholar
Banjade, DP, et al. A novel approach of dose mapping using a humanoid breast phantom in radiotherapy. Br J Radiol 2002; 75:812–818.CrossRefGoogle ScholarPubMed
Venables, K, Winfield, E, Deighton, A, Aird, E, Hoskin, P.Breast radiotherapy phantom design for the START trial. Br J Radiol 2000; 73:1313–1316.CrossRefGoogle ScholarPubMed
Davis, JB, Pfafflin, A, Cozzi, AF.Accuracy of two- and three-dimensional photon dose calculation for tangential irradiation of the breast. J Radiother Oncol 1997; 42:245–248.CrossRefGoogle ScholarPubMed
Back, M, Guerrieri, M, Wratten, C, Steigler, A.Impact of radiation therapy on acute skin toxicity in breast conservation therapy for early breast cancer. Clin Oncol 2004; 16:12–16.Google Scholar
Mettler, F.Medical Effects of Ionizing Radiation. 2nd Edition. Philadelphia: W.B. Saunders Co., 1995.Google Scholar
Archambeau, JO, Pezner, R, Wasserman, T.Pathophysiology of irradiated skin and breast. Int J Radiat Oncol Biol Phys 1995; 31:1171–1185.CrossRefGoogle ScholarPubMed