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An alternative option to reduce lung dose for electron scar boost irradiation in post-mastectomy breast cancer patients with a thin chest wall

Published online by Cambridge University Press:  18 October 2016

Yongsook C. Lee  and
Parvesh Kumar
Yongsook C. Lee*
Affiliation:
Department of Radiation Oncology, University of Arizona, Tucson, AZ, USA
Parvesh Kumar
Affiliation:
Department of Radiation Oncology, University of Nevada, Las Vegas School of Medicine, Las Vegas, NV, USA
*
Correspondence to: Dr Yongsook C. Lee, Department of Radiation Oncology, The University of Arizona, 1501 N. Campbell Avenue, P.O. Box 245081, Tucson, AZ 85724-5081, USA. Tel: 1 520 626 6773. E-mail: dr.cecilialee@hotmail.com
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Abstract

Aim

We evaluated water-equivalent slabs as an alternative to a bolus to reduce radiation dose to the underlying lungs during electron scar boost irradiation in breast cancer patients with a thin chest wall undergoing post-mastectomy radiation therapy.

Materials and methods

Percent depth doses (PDDs) and attenuation factors were obtained for 6 MeV (the lowest electron energy in most clinics) with solid water slabs (1–10 mm by 1 mm increments) placed on top of electron cones. Scatter dose to contralateral breast caused by the solid water slabs was measured on a human-like phantom using two selective scar boost patient setups.

Results

The PDD plots showed that the solid water slabs had similar dosimetric effects to the bolus with lower skin dose to ipsilateral breast for the same thickness. Slab attenuation and scatter dose to the contralateral breast were increased by ~220% and by a factor of 3 with a 5 mm slab, respectively.

Findings

Our results demonstrate the feasibility of using water-equivalent slabs to reduce lung dose for electron scar boost treatment in mastectomy patients with a thin chest wall. However, the increases in treatment time and scatter dose to the contralateral breast are the disadvantages of this approach.

Keywords

breast cancerlung dosepost-mastectomy radiation therapyscar boostthin chest wall
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 16 , Issue 1 , March 2017 , pp. 20 - 28
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Copyright
© Cambridge University Press 2016 

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