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A Radiotherapy Technique to Improve Dose Homogeneity Around Bone Prostheses

Purpose. Following limb conserving surgery for bone or soft tissue sarcoma, patients may require post-operative radiotherapy to minimise the risk of local recurrence. In such circumstances the metal prosthesis reduces the dose in its shadow by approximately 10% when using opposed fields. We describe...

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Autores principales: Williams, M. V., Burnet, N. G., Sherwin, E., Kestelman, R., Geater, A. R., Thomas, S. J., Wilson, C. B.
Formato: Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2004
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2395598/
https://www.ncbi.nlm.nih.gov/pubmed/18521392
http://dx.doi.org/10.1080/13577140410001679248
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author Williams, M. V.
Burnet, N. G.
Sherwin, E.
Kestelman, R.
Geater, A. R.
Thomas, S. J.
Wilson, C. B.
author_facet Williams, M. V.
Burnet, N. G.
Sherwin, E.
Kestelman, R.
Geater, A. R.
Thomas, S. J.
Wilson, C. B.
author_sort Williams, M. V.
collection PubMed
description Purpose. Following limb conserving surgery for bone or soft tissue sarcoma, patients may require post-operative radiotherapy to minimise the risk of local recurrence. In such circumstances the metal prosthesis reduces the dose in its shadow by approximately 10% when using opposed fields. We describe a technique to boost the underdosed area to overcome this problem. Patients or subjects. Seven sequential patients presenting between 1995 and 2001 had their treatment individualised because they had metal prosthesis in the treatment volume. Methods. To improve the target dose homogeneity we used a custom-made keyhole cutout to boost the area in the shadow of the prosthesis. The degree of attenuation caused by the metal prosthesis was estimated and a boost dose calculated. Exit thermoluminescent dosimetry (TLD) was used to confirm the estimates made. Results and discussion. Variation between patients was seen, demonstrating the need for exit TLD to individualise the treatment plan. The use of a boost field provides a method to overcome under-dosage in the shadow of a metal prosthesis. It improves dose homogeneity throughout the target volume and ensures adequate dose intensity around the prosthesis, the site most at risk of local recurrence.
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spelling pubmed-23955982008-06-02 A Radiotherapy Technique to Improve Dose Homogeneity Around Bone Prostheses Williams, M. V. Burnet, N. G. Sherwin, E. Kestelman, R. Geater, A. R. Thomas, S. J. Wilson, C. B. Sarcoma Research Article Purpose. Following limb conserving surgery for bone or soft tissue sarcoma, patients may require post-operative radiotherapy to minimise the risk of local recurrence. In such circumstances the metal prosthesis reduces the dose in its shadow by approximately 10% when using opposed fields. We describe a technique to boost the underdosed area to overcome this problem. Patients or subjects. Seven sequential patients presenting between 1995 and 2001 had their treatment individualised because they had metal prosthesis in the treatment volume. Methods. To improve the target dose homogeneity we used a custom-made keyhole cutout to boost the area in the shadow of the prosthesis. The degree of attenuation caused by the metal prosthesis was estimated and a boost dose calculated. Exit thermoluminescent dosimetry (TLD) was used to confirm the estimates made. Results and discussion. Variation between patients was seen, demonstrating the need for exit TLD to individualise the treatment plan. The use of a boost field provides a method to overcome under-dosage in the shadow of a metal prosthesis. It improves dose homogeneity throughout the target volume and ensures adequate dose intensity around the prosthesis, the site most at risk of local recurrence. Hindawi Publishing Corporation 2004-03 /pmc/articles/PMC2395598/ /pubmed/18521392 http://dx.doi.org/10.1080/13577140410001679248 Text en Copyright © 2004 Hindawi Publishing Corporation. http://creativecommons.org/licenses/by/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Williams, M. V.
Burnet, N. G.
Sherwin, E.
Kestelman, R.
Geater, A. R.
Thomas, S. J.
Wilson, C. B.
A Radiotherapy Technique to Improve Dose Homogeneity Around Bone Prostheses
title A Radiotherapy Technique to Improve Dose Homogeneity Around Bone Prostheses
title_full A Radiotherapy Technique to Improve Dose Homogeneity Around Bone Prostheses
title_fullStr A Radiotherapy Technique to Improve Dose Homogeneity Around Bone Prostheses
title_full_unstemmed A Radiotherapy Technique to Improve Dose Homogeneity Around Bone Prostheses
title_short A Radiotherapy Technique to Improve Dose Homogeneity Around Bone Prostheses
title_sort radiotherapy technique to improve dose homogeneity around bone prostheses
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2395598/
https://www.ncbi.nlm.nih.gov/pubmed/18521392
http://dx.doi.org/10.1080/13577140410001679248
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