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A dosimetry study of post‐mastectomy radiation therapy with AeroForm tissue expander

PURPOSE: To evaluate the dosimetric effects of the AeroForm(TM) (AirXanpders®, Palo Alto, CA) tissue expander in‐situ for breast cancer patients receiving post‐mastectomy radiation therapy. METHODS AND MATERIALS: A film phantom (P1) was constructed by placing the metallic canister of the AeroForm on...

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Autores principales: Lim, Seng Boh, Kuo, Li Cheng, Li, Guang, Kuo, Hsiang‐Chi, McCormick, Beryl, Cahlon, Oren, Powell, Simon, Hong, Linda X.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7497932/
https://www.ncbi.nlm.nih.gov/pubmed/32614518
http://dx.doi.org/10.1002/acm2.12962
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author Lim, Seng Boh
Kuo, Li Cheng
Li, Guang
Kuo, Hsiang‐Chi
McCormick, Beryl
Cahlon, Oren
Powell, Simon
Hong, Linda X.
author_facet Lim, Seng Boh
Kuo, Li Cheng
Li, Guang
Kuo, Hsiang‐Chi
McCormick, Beryl
Cahlon, Oren
Powell, Simon
Hong, Linda X.
author_sort Lim, Seng Boh
collection PubMed
description PURPOSE: To evaluate the dosimetric effects of the AeroForm(TM) (AirXanpders®, Palo Alto, CA) tissue expander in‐situ for breast cancer patients receiving post‐mastectomy radiation therapy. METHODS AND MATERIALS: A film phantom (P1) was constructed by placing the metallic canister of the AeroForm on a solid water phantom with EBT3 films at five depths ranging from 2.6 mm to 66.2 mm. A breast phantom (P2), a three‐dimensional printed tissue‐equivalent breast with fully expanded AeroForm in‐situ, was placed on a thorax phantom. A total of 21 optical luminescent dosimeters (OLSDs) were placed on the anterior skin–gas interface and the posterior chest wall–metal interface of the AeroForm. Both phantoms were imaged with a 16‐bit computed tomography scanner with orthopedic metal artifact reduction. P1 was irradiated with an open field utilizing 6 MV and 15 MV photon beams at 0°, 90°, and 270°. P2 was irradiated using a volumetric modulated arc therapy plan with a 6 MV photon beam and a tangential plan with a 15 MV photon beam. All doses were calculated using Eclipse (Varian, Palo Alto, CA) with AAA and AcurosXB (AXB) algorithms. RESULTS: The average dose differences between film measurements and AXB in the region adjacent to the canister in P1 were within 3.1% for 15 MV and 0.9% for 6 MV. Local dose differences over 10% were also observed. In the chest wall region of P2, the median dose of OLSDs in percentage of prescription dose were 108.4% (range 95.4%–113.0%) for the 15MV tangential plan and 110.4% (range 99.1%–113.8%) for the 6MV volumetric modulated arc therapy plan. In the skin–gas interface, the median dose of the OLSDs were 102.3% (range 92.7%–107.7%) for the 15 MV plan and 108.2% (range 97.8–113.5%) for the 6 MV plan. Measured doses were, in general, higher than calculated doses with AXB calculations. The AAA dose algorithms produced results with slightly larger discrepancies between measurements compared with AXB. CONCLUSIONS: The AeroForm creates significant dose uncertainties in the chest wall–metal interface. The AcurosXB dose calculation algorithm is recommended for more accurate calculations. If possible, post‐mastectomy radiation therapy should be delivered after the permanent implant is in place.
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spelling pubmed-74979322020-09-25 A dosimetry study of post‐mastectomy radiation therapy with AeroForm tissue expander Lim, Seng Boh Kuo, Li Cheng Li, Guang Kuo, Hsiang‐Chi McCormick, Beryl Cahlon, Oren Powell, Simon Hong, Linda X. J Appl Clin Med Phys Radiation Oncology Physics PURPOSE: To evaluate the dosimetric effects of the AeroForm(TM) (AirXanpders®, Palo Alto, CA) tissue expander in‐situ for breast cancer patients receiving post‐mastectomy radiation therapy. METHODS AND MATERIALS: A film phantom (P1) was constructed by placing the metallic canister of the AeroForm on a solid water phantom with EBT3 films at five depths ranging from 2.6 mm to 66.2 mm. A breast phantom (P2), a three‐dimensional printed tissue‐equivalent breast with fully expanded AeroForm in‐situ, was placed on a thorax phantom. A total of 21 optical luminescent dosimeters (OLSDs) were placed on the anterior skin–gas interface and the posterior chest wall–metal interface of the AeroForm. Both phantoms were imaged with a 16‐bit computed tomography scanner with orthopedic metal artifact reduction. P1 was irradiated with an open field utilizing 6 MV and 15 MV photon beams at 0°, 90°, and 270°. P2 was irradiated using a volumetric modulated arc therapy plan with a 6 MV photon beam and a tangential plan with a 15 MV photon beam. All doses were calculated using Eclipse (Varian, Palo Alto, CA) with AAA and AcurosXB (AXB) algorithms. RESULTS: The average dose differences between film measurements and AXB in the region adjacent to the canister in P1 were within 3.1% for 15 MV and 0.9% for 6 MV. Local dose differences over 10% were also observed. In the chest wall region of P2, the median dose of OLSDs in percentage of prescription dose were 108.4% (range 95.4%–113.0%) for the 15MV tangential plan and 110.4% (range 99.1%–113.8%) for the 6MV volumetric modulated arc therapy plan. In the skin–gas interface, the median dose of the OLSDs were 102.3% (range 92.7%–107.7%) for the 15 MV plan and 108.2% (range 97.8–113.5%) for the 6 MV plan. Measured doses were, in general, higher than calculated doses with AXB calculations. The AAA dose algorithms produced results with slightly larger discrepancies between measurements compared with AXB. CONCLUSIONS: The AeroForm creates significant dose uncertainties in the chest wall–metal interface. The AcurosXB dose calculation algorithm is recommended for more accurate calculations. If possible, post‐mastectomy radiation therapy should be delivered after the permanent implant is in place. John Wiley and Sons Inc. 2020-07-02 /pmc/articles/PMC7497932/ /pubmed/32614518 http://dx.doi.org/10.1002/acm2.12962 Text en © 2020 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals LLC on behalf of American Association of Physicists in Medicine. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Radiation Oncology Physics
Lim, Seng Boh
Kuo, Li Cheng
Li, Guang
Kuo, Hsiang‐Chi
McCormick, Beryl
Cahlon, Oren
Powell, Simon
Hong, Linda X.
A dosimetry study of post‐mastectomy radiation therapy with AeroForm tissue expander
title A dosimetry study of post‐mastectomy radiation therapy with AeroForm tissue expander
title_full A dosimetry study of post‐mastectomy radiation therapy with AeroForm tissue expander
title_fullStr A dosimetry study of post‐mastectomy radiation therapy with AeroForm tissue expander
title_full_unstemmed A dosimetry study of post‐mastectomy radiation therapy with AeroForm tissue expander
title_short A dosimetry study of post‐mastectomy radiation therapy with AeroForm tissue expander
title_sort dosimetry study of post‐mastectomy radiation therapy with aeroform tissue expander
topic Radiation Oncology Physics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7497932/
https://www.ncbi.nlm.nih.gov/pubmed/32614518
http://dx.doi.org/10.1002/acm2.12962
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