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A novel approach for superficial intraoperative radiotherapy (IORT) using a 50 kV X‐ray source: a technical and case report

The use of IORT as a treatment modality for patients with close or positive margins has increased over the past decade. For situations where a flat area (up to 6 cm in diameter) has to be treated intraoperatively, new applicators for superficial treatment with a miniature X‐ray source (INTRABEAM sys...

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Autores principales: Schneider, Frank, Clausen, Sven, Thölking, Johannes, Wenz, Frederik, Abo‐Madyan, Yasser
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5711231/
https://www.ncbi.nlm.nih.gov/pubmed/24423847
http://dx.doi.org/10.1120/jacmp.v15i1.4502
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author Schneider, Frank
Clausen, Sven
Thölking, Johannes
Wenz, Frederik
Abo‐Madyan, Yasser
author_facet Schneider, Frank
Clausen, Sven
Thölking, Johannes
Wenz, Frederik
Abo‐Madyan, Yasser
author_sort Schneider, Frank
collection PubMed
description The use of IORT as a treatment modality for patients with close or positive margins has increased over the past decade. For situations where a flat area (up to 6 cm in diameter) has to be treated intraoperatively, new applicators for superficial treatment with a miniature X‐ray source (INTRABEAM system) were developed. Here we report our evaluation of the dosimetric characteristics of these new applicators and their first clinical use. Each of these flat and surface applicators consists of a radiation protective metal tube and a flattening filter, which converts the spherical dose distribution of the X‐ray source into a flat one. The homogeneity of each dose distribution and depth‐dose measurements were evaluated using film dosimetry in a solid water phantom and a soft X‐ray ionization chamber in a water tank. The first patient was treated with 5 Gy delivered in 5 mm using a 4 cm FLAT applicator over 21 minutes. The flat applicators show the maximum homogeneity, with a uniformity ratio of 1.02‐1.08 in certain depths. In 1 mm depth surface applicators show a uniformity ratio of 1.15‐1.28. They also show a higher dose rate and a steeper dose gradient compared to the flat applicators. The results of this investigation demonstrated that the flat and surface applicators have unique dosimetric characteristics that need to be considered during the treatment planning stages. This work also showed that it is possible to perform a superficial localized IORT which provides new application possibilities for use of the INTRABEAM system. PACS number: 87.55.ne
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spelling pubmed-57112312018-04-02 A novel approach for superficial intraoperative radiotherapy (IORT) using a 50 kV X‐ray source: a technical and case report Schneider, Frank Clausen, Sven Thölking, Johannes Wenz, Frederik Abo‐Madyan, Yasser J Appl Clin Med Phys Radiation Oncology Physics The use of IORT as a treatment modality for patients with close or positive margins has increased over the past decade. For situations where a flat area (up to 6 cm in diameter) has to be treated intraoperatively, new applicators for superficial treatment with a miniature X‐ray source (INTRABEAM system) were developed. Here we report our evaluation of the dosimetric characteristics of these new applicators and their first clinical use. Each of these flat and surface applicators consists of a radiation protective metal tube and a flattening filter, which converts the spherical dose distribution of the X‐ray source into a flat one. The homogeneity of each dose distribution and depth‐dose measurements were evaluated using film dosimetry in a solid water phantom and a soft X‐ray ionization chamber in a water tank. The first patient was treated with 5 Gy delivered in 5 mm using a 4 cm FLAT applicator over 21 minutes. The flat applicators show the maximum homogeneity, with a uniformity ratio of 1.02‐1.08 in certain depths. In 1 mm depth surface applicators show a uniformity ratio of 1.15‐1.28. They also show a higher dose rate and a steeper dose gradient compared to the flat applicators. The results of this investigation demonstrated that the flat and surface applicators have unique dosimetric characteristics that need to be considered during the treatment planning stages. This work also showed that it is possible to perform a superficial localized IORT which provides new application possibilities for use of the INTRABEAM system. PACS number: 87.55.ne John Wiley and Sons Inc. 2014-01-06 /pmc/articles/PMC5711231/ /pubmed/24423847 http://dx.doi.org/10.1120/jacmp.v15i1.4502 Text en © 2014 The Authors. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/3.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Radiation Oncology Physics
Schneider, Frank
Clausen, Sven
Thölking, Johannes
Wenz, Frederik
Abo‐Madyan, Yasser
A novel approach for superficial intraoperative radiotherapy (IORT) using a 50 kV X‐ray source: a technical and case report
title A novel approach for superficial intraoperative radiotherapy (IORT) using a 50 kV X‐ray source: a technical and case report
title_full A novel approach for superficial intraoperative radiotherapy (IORT) using a 50 kV X‐ray source: a technical and case report
title_fullStr A novel approach for superficial intraoperative radiotherapy (IORT) using a 50 kV X‐ray source: a technical and case report
title_full_unstemmed A novel approach for superficial intraoperative radiotherapy (IORT) using a 50 kV X‐ray source: a technical and case report
title_short A novel approach for superficial intraoperative radiotherapy (IORT) using a 50 kV X‐ray source: a technical and case report
title_sort novel approach for superficial intraoperative radiotherapy (iort) using a 50 kv x‐ray source: a technical and case report
topic Radiation Oncology Physics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5711231/
https://www.ncbi.nlm.nih.gov/pubmed/24423847
http://dx.doi.org/10.1120/jacmp.v15i1.4502
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