Intensity modulated proton therapy for postmastectomy radiation of bilateral implant reconstructed breasts: A treatment planning study
| Autor: | Shannon M. MacDonald, T Halabi, C. Gomà, Sean McBride, Hanne M. Kooy, Rachel B. Jimenez, Alphonse G. Taghian, Jacqueline A. Nyamwanda, Brian Napolitano, Hsiao-Ming Lu |
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| Rok vydání: | 2013 |
| Předmět: |
Mammaplasty
medicine.medical_treatment Breast Neoplasms Breast cancer Proton Therapy Humans Medicine Radiology Nuclear Medicine and imaging Radiation treatment planning Proton therapy Mastectomy business.industry Radiotherapy Planning Computer-Assisted Radiotherapy Dosage Hematology medicine.disease Radiation therapy Oncology Female Implant Radiotherapy Conformal business Breast reconstruction Nuclear medicine |
| Zdroj: | Radiotherapy and Oncology. 107:213-217 |
| ISSN: | 0167-8140 |
| Popis: | Background and purpose Delivery of post-mastectomy radiation (PMRT) in women with bilateral implants represents a technical challenge, particularly when attempting to cover regional lymph nodes. Intensity modulated proton therapy (IMPT) holds the potential to improve dose delivery and spare non-target tissues. The purpose of this study was to compare IMPT to three-dimensional (3D) conformal radiation following bilateral mastectomy and reconstruction. Materials and methods Ten IMPT, 3D conformal photon/electron (P/E), and 3D photon (wide tangent) plans were created for 5 patients with breast cancer, all of whom had bilateral breast implants. Using RTOG guidelines, a physician delineated contours for both target volumes and organs-at-risk. Plans were designed to achieve 95% coverage of all targets (chest wall, IMN, SCV, axilla) to a dose of 50.4 Gy or Gy (RBE) while maximally sparing organs-at-risk. Results IMPT plans conferred similar target volume coverage with enhanced homogeneity. Both mean heart and lung doses using IMPT were significantly decreased compared to both P/E and wide tangent planning. Conclusions IMPT provides improved homogeneity to the chest wall and regional lymphatics in the post-mastectomy setting with improved sparing of surrounding normal structures for woman with reconstructed breasts. IMPT may enable women with mastectomy to undergo radiation therapy without the need for delay in breast reconstruction. |
| Databáze: | OpenAIRE |
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