The transition in practice to reduce bolus use in post-mastectomy radiotherapy: A dosimetric study of skin and subcutaneous tissue.

To inform clinical practice for women receiving post-mastectomy radiotherapy (PMRT), this study demonstrates the dosimetric impact of removing daily bolus on skin and subcutaneous tissue. Two planning strategies were used: clinical field-based (n = 30) and volume-based planning (n = 10). The clinical field-based plans were created with bolus and recalculated without bolus for comparison.

Dosimetric consequences of seed placement accuracy in permanent breast seed implant brachytherapy.

Purpose: This study quantifies the dosimetric impact of implant accuracy and derives a quantitative relationship relating implant accuracy to target dosimetry.

Methods And Materials: A framework was developed to simulate multiple implants for error combinations. Spherical clinical target volumes (CTVs) were modeled with volumes 1.

Peer-based credentialing for brachytherapy: Application in permanent seed implant.

Purpose: The purpose of the study was to establish a quantitative method for implant quality evaluation in permanent seed implant brachytherapy for credentialing. Delivery-based credentialing will promote consistency in brachytherapy seed delivery and improve patient outcomes.

Methods: A workflow for delivery-based credentialing was outlined and applied to permanent breast seed implant brachytherapy.

Establishing a simulation-based education program for radiation oncology learners in permanent seed implant brachytherapy: Building validation evidence.

Purpose: The purpose of this study was to establish a simulation-based education program for radiation oncology learners in permanent seed implant brachytherapy. The first step in formalizing any education program is a validation process that builds evidence-based verification that the learning environment is appropriate.

Methods And Materials: The primary education task allowed practitioners to use an anthropomorphic breast phantom to simulate a permanent seed implant brachytherapy delivery.

Clinical implementation of AXB from AAA for breast: Plan quality and subvolume analysis.

Purpose: Two dose calculation algorithms are available in Varian Eclipse software: Anisotropic Analytical Algorithm (AAA) and Acuros External Beam (AXB). Many Varian Eclipse-based centers have access to AXB; however, a thorough understanding of how it will affect plan characteristics and, subsequently, clinical practice is necessary prior to implementation. We characterized the difference in breast plan quality between AXB and AAA for dissemination to clinicians during implementation.

Technical Note: Issues related to external marker block placement for deep inspiration breath hold breast radiotherapy.

Purpose: It has been suggested that the Real-time Position Management (RPM) marker block should be placed directly on the breast or sternum to verify deep inspiration breath hold (DIBH) level for breast radiotherapy. We explore three potential issues with this practice: (a) surface dose effect of placing the marker block in the primary beam; (b) effect of marker block tilt on the accuracy of the RPM system; and (c) correlation between marker block positions on the patient surface and internal chest wall position.

Methods: (a) The surface dose under the two-, four-, and six-dot marker blocks was measured at incident angles of 0° and 30°; (b) the motion amplitude detected when using the two- and six-dot marker blocks was recorded for block tilts from 0° to 60° about the RPM camera line of sight; (c) the correlation between median displacement of the chest wall and median displacement of the surface contour between breath holds was investigated for superior, middle, and inferior block positions using contours extracted from portal images of eight left-sided breast cancer patients.