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Skin dose assessment with treatment planning system (TPS) and skin reaction evaluation of early breast cancer patients treated via an intraoperative radiation therapy (IORT) device

Published online by Cambridge University Press:  16 August 2018

Omid Baziar ,
Hamid Gholamhosseinian  and
Mohammad Naser Forghani
Omid Baziar
Affiliation:
Department of Medical Physics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Hamid Gholamhosseinian*
Affiliation:
Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Mohammad Naser Forghani
Affiliation:
Department of General Surgery, Mashhad University of Medical Sciences, Mashhad, Iran
*
Author for correspondence: Hamid Gholamhosseinian, Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Tel: +9891 5306 6188. E-mail: gholamhosseinianh@mums.ac.ir
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Abstract

Purpose

To assess skin dose and incidence of skin reactions in early breast cancer patients treated via Intrabeam™ intraoperative radiation therapy (IORT) device.

Materials and methods

In total, 250 breast cancer patients treated with a single fraction of 20 Gy using 50 kV photon were recruited. The applicator to skin distance (ASD) was measured before the initiation of the radiation and the skin dose in each patient was accordingly calculated based on the treatment planning system (TPS).

Results

The average skin doses calculated were equal to 7·91, 5·83, 3·96 and 2·14 Gy for 6–10, 10–15, 15–20 and 20–30 mm ASD values, respectively. It is noticeable that the skin doses could be lower than the TPS measurements up to 45%, mostly due to lack of backscatter radiation in breast tissue compared with the full scatter condition in the Zeiss water phantom. Finally, only three patients showed low-grade skin reactions 1 week after IORT. A review of the related literature also revealed the incidence of lower skin complications among patients treated via Intrabeam™ compared with MammoSite™ machine.

Conclusions

The Intrabeam™ TPS did not seem to be very reliable for accurate skin dosimetry. However, breast cancer treatment using Intrabeam™ could result in fewer incidences of skin reactions than MammoSite™ machine.

Keywords

breast cancer treatmentIntrabeam™ deviceMammoSite™ machineskin reactiontreatment planning system (TPS) dosimetry
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 17 , Issue 4 , December 2018 , pp. 417 - 421
Copyright
© Cambridge University Press 2018 

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