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Feasibility of using nonflat photon beams for whole‐breast irradiation with breath hold
Removing a flattening filter or replacing it with a thinner filter alters the characteristics of a photon beam, creating a forward peaked intensity profile to make the photon beam nonflat. This study is to investigate the feasibility of applying nonflat photon beams to the whole‐breast irradiation w...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5711254/ https://www.ncbi.nlm.nih.gov/pubmed/24423835 http://dx.doi.org/10.1120/jacmp.v15i1.4397 |
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author | Wang, Yuenan Vassil, Andrew Tendulkar, Rahul Bayouth, John Xia, Ping |
author_facet | Wang, Yuenan Vassil, Andrew Tendulkar, Rahul Bayouth, John Xia, Ping |
author_sort | Wang, Yuenan |
collection | PubMed |
description | Removing a flattening filter or replacing it with a thinner filter alters the characteristics of a photon beam, creating a forward peaked intensity profile to make the photon beam nonflat. This study is to investigate the feasibility of applying nonflat photon beams to the whole‐breast irradiation with breath holds for a potential of delivery time reduction during the gated treatment. Photon beams of 6 MV with flat and nonflat intensity profiles were commissioned. Fifteen patients with early‐stage breast cancer, who received whole‐breast radiation without breathing control, were retrospectively selected for this study. For each patient, three plans were created using a commercial treatment planning system: (a) the clinically approved plan using forward planning method (FP); (b) a hybrid intensity‐modulated radiation therapy (IMRT) plan where the flat beam open fields were combined with the nonflat beam IMRT fields using direct aperture optimization method (mixed DAO); (c) a hybrid IMRT plan where both open and IMRT fields were from nonflat beams using direct aperture optimization (nonflat DAO). All plans were prescribed for [Formula: see text] of the breast volume receiving the prescription dose of 50 Gy (2.0 Gy per fraction). In comparison, all plans achieved a similar dosimetric coverage to the targeted volume. The average homogeneity index of the FP, mixed DAO, and nonflat DAO plans were [Formula: see text] , [Formula: see text] , and [Formula: see text] , respectively. The average percentage volume of [Formula: see text] was [Formula: see text] , [Formula: see text] , [Formula: see text] for the FP, mixed, and nonflat DAO plans, respectively. There was no significant difference [Formula: see text] observed for the defined endpoint doses in organs at risk (OARs). In conclusion, both mixed DAO and nonflat DAO plans can achieve similar plan quality as the clinically approved FP plan, measured by plan homogeneity and endpoint doses to the ORAs. Nonflat beam plans may reduce treatment time in breath‐hold treatment, especially for hypofractionated treatment. PACS number: 87.55 |
format | Online Article Text |
id | pubmed-5711254 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-57112542018-04-02 Feasibility of using nonflat photon beams for whole‐breast irradiation with breath hold Wang, Yuenan Vassil, Andrew Tendulkar, Rahul Bayouth, John Xia, Ping J Appl Clin Med Phys Radiation Oncology Physics Removing a flattening filter or replacing it with a thinner filter alters the characteristics of a photon beam, creating a forward peaked intensity profile to make the photon beam nonflat. This study is to investigate the feasibility of applying nonflat photon beams to the whole‐breast irradiation with breath holds for a potential of delivery time reduction during the gated treatment. Photon beams of 6 MV with flat and nonflat intensity profiles were commissioned. Fifteen patients with early‐stage breast cancer, who received whole‐breast radiation without breathing control, were retrospectively selected for this study. For each patient, three plans were created using a commercial treatment planning system: (a) the clinically approved plan using forward planning method (FP); (b) a hybrid intensity‐modulated radiation therapy (IMRT) plan where the flat beam open fields were combined with the nonflat beam IMRT fields using direct aperture optimization method (mixed DAO); (c) a hybrid IMRT plan where both open and IMRT fields were from nonflat beams using direct aperture optimization (nonflat DAO). All plans were prescribed for [Formula: see text] of the breast volume receiving the prescription dose of 50 Gy (2.0 Gy per fraction). In comparison, all plans achieved a similar dosimetric coverage to the targeted volume. The average homogeneity index of the FP, mixed DAO, and nonflat DAO plans were [Formula: see text] , [Formula: see text] , and [Formula: see text] , respectively. The average percentage volume of [Formula: see text] was [Formula: see text] , [Formula: see text] , [Formula: see text] for the FP, mixed, and nonflat DAO plans, respectively. There was no significant difference [Formula: see text] observed for the defined endpoint doses in organs at risk (OARs). In conclusion, both mixed DAO and nonflat DAO plans can achieve similar plan quality as the clinically approved FP plan, measured by plan homogeneity and endpoint doses to the ORAs. Nonflat beam plans may reduce treatment time in breath‐hold treatment, especially for hypofractionated treatment. PACS number: 87.55 John Wiley and Sons Inc. 2014-01-06 /pmc/articles/PMC5711254/ /pubmed/24423835 http://dx.doi.org/10.1120/jacmp.v15i1.4397 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 Wang, Yuenan Vassil, Andrew Tendulkar, Rahul Bayouth, John Xia, Ping Feasibility of using nonflat photon beams for whole‐breast irradiation with breath hold |
title | Feasibility of using nonflat photon beams for whole‐breast irradiation with breath hold |
title_full | Feasibility of using nonflat photon beams for whole‐breast irradiation with breath hold |
title_fullStr | Feasibility of using nonflat photon beams for whole‐breast irradiation with breath hold |
title_full_unstemmed | Feasibility of using nonflat photon beams for whole‐breast irradiation with breath hold |
title_short | Feasibility of using nonflat photon beams for whole‐breast irradiation with breath hold |
title_sort | feasibility of using nonflat photon beams for whole‐breast irradiation with breath hold |
topic | Radiation Oncology Physics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5711254/ https://www.ncbi.nlm.nih.gov/pubmed/24423835 http://dx.doi.org/10.1120/jacmp.v15i1.4397 |
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