Flattening Filter Free vs Flattened Beams for Breast Irradiation
Autor: | Derek H. F. Rietveld, Max Dahele, Marloes Jeulink, Kees Spruijt, Johan P. Cuijpers, Wilko F.A.R. Verbakel, Ben J. Slotman |
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Přispěvatelé: | Radiation Oncology, CCA - Innovative therapy |
Rok vydání: | 2013 |
Předmět: |
Organs at Risk
Simultaneous integrated boost Cancer Research Time Factors Radiography Breast Neoplasms Radiation Dosage Imaging phantom Beam delivery Humans Medicine Radiology Nuclear Medicine and imaging Breast Irradiation Lung Photons Radiation Flattening filter free business.industry Radiotherapy Planning Computer-Assisted Heart Radiotherapy Dosage Tumor Burden Oncology Ionization chamber Female Radiotherapy Intensity-Modulated business Dose rate Nuclear medicine Algorithms Filtration |
Zdroj: | International journal of radiation oncology, biology, physics, 85(2), 506-513. Elsevier Inc. Spruijt, K H, Dahele, M R, Cuijpers, J P, Jeulink, M, Rietveld, D H F, Slotman, B J & Verbakel, W F A R 2013, ' Flattening Filter Free vs Flattened Beams for Breast Irradiation ', International journal of radiation oncology, biology, physics, vol. 85, no. 2, pp. 506-513 . https://doi.org/10.1016/j.ijrobp.2012.03.040 |
ISSN: | 0360-3016 |
DOI: | 10.1016/j.ijrobp.2012.03.040 |
Popis: | Purpose Flattening filter free (FFF) beams offer the potential for a higher dose rate, shorter treatment time, and lower peripheral dose. To investigate their role in large-field treatments, this study compared flattened and FFF beams for breast irradiation. Methods and Materials Ten left breast clinical plans comprising 2 tangential beams and a medially located 3-field simultaneous integrated boost (SIB) were replanned. Full intensity modulated radiotherapy (IMRT), hybrid IMRT, electronic tissue compensator (ETC), and multiple static field treatment plans were created for the elective breast volume using flattened and FFF beams, in combination with a 3-field IMRT SIB. Plan quality was assessed and delivery times were measured for all plans for 1 patient. Out-of-field doses were measured using an ionization chamber for an IMRT plan optimized on a corner of simple cubic phantom for both flattened and FFF beams. Results For each technique, mean target volume metrics (planning target volume coverage, homogeneity, conformity) were typically within 3% for flattened and FFF beams. Larger mean differences in boost conformity favoring flattened hybrid (7.2%) and full IMRT (5.5%) plans may have reflected limitations in plan normalization. Calculated heart and ipsilateral lung doses were comparable; however, both flattened and FFF low-dose phantom measurements were substantially higher than calculated values, rendering the comparison of low dose in the contralateral breast uncertain. Beam delivery times were on average 31% less for FFF. Conclusions In general, target volume metrics for flattened and FFF plans were comparable. The planning system did not seem to allow for accurate peripheral dose evaluation. FFF was associated with a potentially shorter treatment time. All 4 IMRT techniques allowed FFF beams to generate acceptable plans for breast IMRT. |
Databáze: | OpenAIRE |
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