Clinical implementation of enhanced dynamic wedges into the Pinnacle treatment planning system: Monte Carlo validation and patient-specific QA.

The goal of this work is to present a systematic Monte Carlo validation study on the clinical implementation of the enhanced dynamic wedges (EDWs) into the Pinnacle(3) (Philips Medical Systems, Fitchburg, WI) treatment planning system (TPS) and QA procedures for patient plan verification treated with EDWs. Modeling of EDW beams in the Pinnacle(3) TPS, which employs a collapsed-cone convolution superposition (CCCS) dose model, was based on a combination of measured open-beam data and the 'Golden Segmented Treatment Table' (GSTT) provided by Varian for each photon beam energy. To validate EDW models, dose profiles of 6 and 10 MV photon beams from a Clinac 2100 C/D were measured in virtual water at depths from near-surface to 30 cm for a wide range of field sizes and wedge angles using the Profiler 2 (Sun Nuclear Corporation, Melbourne, FL) diode array system.

Clinical implementation of prostate image guided radiation therapy: a prospective study to define the optimal field of interest and image registration technique using automated x-ray volumetric imaging software.

Alignment of the CBCT with the reference CT is called image registration (IR). The parameters for utilizing the automated Elekta XVI IR software for IGRT of the prostate still remain to be defined. In this study, we compare several automated XVI IR parameters to manual registration to identify the optimal automated IR technique for the prostate gland.

Treatment of primary cutaneous CD30+ anaplastic large-cell lymphoma with radiation therapy.

Purpose: Primary cutaneous CD30+ anaplastic large-cell lymphoma (CALCL) is a relatively rare and indolent variant of cutaneous T-cell lymphoma (CTCL). This report examines the response of localized disease to radiation alone.

Methods: The Yale Cancer Center records were examined, and all patients with CTCL from January 1, 2001, to September 1, 2006, evaluated in the Department of Therapeutic Radiology were identified.

Effects of breast-conserving therapy on lactation after pregnancy.

Background: As the incidence of breast-conserving therapy in women of childbearing years increases, patient concerns regarding subsequent pregnancies and lactation have become more prevalent. There is a paucity of data regarding lactation outcomes in women who have undergone breast-conserving therapy and then sustained full-term pregnancies. Our objective was to evaluate lactation outcomes in patients with early-stage breast cancer treated with breast-conserving therapy.

Improved treatment of pelvis and inguinal nodes using modified segmental boost technique: dosimetric evaluation.

Purpose: To describe a novel, yet simple, modified segmental boost technique (MSBT) and to compare the dosimetry of our method with that of other traditional methods of treatment for the pelvis and inguinal nodes.

Methods And Materials: We developed a radiotherapy technique that uses linear accelerators with multileaf collimators to treat the pelvis and sequentially boost the inguinal regions, while minimizing "hot spots" across the match-line. This was achieved by angling the gantry for the inguinal fields so that their medial borders aligned with the divergence of the posterior pelvic field.