Dosimetric comparison of proton and photon three-dimensional, conformal, external beam accelerated partial breast irradiation techniques
| Autor: | Kevin R. Kozak, Jacqueline A. Nyamwanda, Alphonse G. Taghian, Karen P. Doppke, Thomas F. DeLaney, J.K. Feng, Judith Adams, Elizabeth Crowley, Angela Katz |
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| Rok vydání: | 2006 |
| Předmět: |
Cancer Research
medicine.medical_specialty medicine.medical_treatment Radiography Breast Neoplasms Mastectomy Segmental Breast cancer Proton Therapy medicine Humans Dosimetry Radiology Nuclear Medicine and imaging Proton therapy Aged Photons Radiation business.industry Carcinoma Ductal Breast Lumpectomy Partial Breast Irradiation Radiotherapy Dosage Middle Aged medicine.disease Radiation therapy Carcinoma Lobular Oncology Case-Control Studies Female Radiology Radiotherapy Conformal business Nuclear medicine Mastectomy |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 65:1572-1578 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2006.04.025 |
| Popis: | Purpose: To compare the dosimetry of proton and photon-electron three-dimensional, conformal, external beam accelerated partial breast irradiation (3D-CPBI). Methods and Materials: Twenty-four patients with fully excised, Stage I breast cancer treated with adjuvant proton 3D-CPBI had treatment plans generated using the mixed-modality, photon-electron 3D-CPBI technique. To facilitate dosimetric comparisons, planning target volumes (PTVs; lumpectomy site plus 1.5–2.0 cm margin) and prescribed dose (32 Gy) were held constant. Plans were optimized for PTV coverage and normal tissue sparing. Results: Proton and mixed-modality plans both provided acceptable PTV coverage with 95% of the PTV receiving 90% of the prescribed dose in all cases. Both techniques also provided excellent dose homogeneity with a dose maximum exceeding 110% of the prescribed dose in only one case. Proton 3D-CPBI reduced the volume of nontarget breast tissue receiving 50% of the prescribed dose by an average of 36%. Statistically significant reductions in the volume of total ipsilateral breast receiving 100%, 75%, 50%, and 25% of the prescribed dose were also observed. The use of protons resulted in small, but statistically significant, reductions in the radiation dose delivered to 5%, 10%, and 20% of ipsilateral and contralateral lung and heart. The nontarget breast tissue dosimetric advantages of proton 3D-CPBI were not dependent on tumor location, breast size, PTV size, or the ratio of PTV to breast volume. Conclusions: Compared to photon-electron 3D-CPBI, proton 3D-CPBI significantly reduces the volume of irradiated nontarget breast tissue. Both approaches to accelerated partial breast irradiation offer exceptional lung and heart sparing. |
| Databáze: | OpenAIRE |
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