Purpose: Many authors have studied the problems associated with the three-field breast treatment, yet the proposed solutions present their own difficulties. This study presents a technique that overcomes these difficulties, reduces scatter to the contralateral breast, and improves setup reproducibility.
Methods And Materials: Patients are set up with both arms raised superiorly on a breast board. A precise field-match is achieved by rotating the couch and collimator of the tangents, while the supraclavicular field is half-beam blocked using an independent jaw. The posterior borders of the tangents are conformally defined by multileaf collimation. Measurements were performed to verify the field matching and evaluate scatter doses.
Result: A smooth dose transition was found at the match line at all depths. Corner blocks and lower wedges were not used, which reduced the scatter to the contralateral breast compared with our prior technique.
Conclusion: The technique achieves a precise match while removing constraints on the tangents' length and decreasing scatter dose. Procedures for simulation, planning, and treatment have been devised, along with a new patient setup routine incorporating orthogonal setup films and tattoos. This technique has been successfully implemented in routine treatment since September 2001. A program calculating the setup parameters is available at our website.
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http://dx.doi.org/10.1016/s0360-3016(02)04514-5 | DOI Listing |
J Appl Clin Med Phys
May 2024
Department of Radiation Oncology, University of California, Los Angeles, California, USA.
Purpose/objective: Field size limitations on Halcyon and Ethos treatment machines largely preclude use of the conventional monoisocentric three-field technique for breast/chest wall and regional lymph nodes. We present an alternative, IMRT-based planning approach that facilitates treatment on Halcyon and Ethos while preserving plan quality.
Materials/methods: Eight breast and regional node cases (four left-sided, four right-sided) were planned for an Ethos machine using a 15-17 field IMRT technique.
Ann Gastroenterol Surg
July 2023
Japan Society for Surgical Infection Tokyo Japan.
Aim: This study was performed to evaluate the oncological impact of surgical site infection (SSI) and pneumonia on long-term outcomes after esophagectomy.
Methods: The Japan Society for Surgical Infection conducted a multicenter retrospective cohort study involving 407 patients with curative stage I/II/III esophageal cancer at 11 centers from April 2013 to March 2015. We investigated the association of SSI and postoperative pneumonia with oncological outcomes in terms of relapse-free survival (RFS) and overall survival (OS).
J Appl Clin Med Phys
February 2023
Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Rep Pract Oncol Radiother
July 2022
Center of Radiotherapy, National Institute of Oncology, Budapest, Hungary.
Background: The purpose of this study was to investigate the dose coverage of sentinel lymph nodes (SLN), level I, II and III axillary volumes from tangent fields for breast cancer patients with positive SLN without axillary dissection.
Materials And Methods: In 30 patients with cN0 invasive breast cancer treated with breast conserving surgery and SLN biopsy, the SLN area was intraoperatively marked with a titanium clip. Retrospectively, the SLN area and axillary target volumes were contoured, and three plans [standard tangent fields (STgF), high tangent fields (HTgF), and STgF + axillary-supraclavicular field] were generated for each patient.
Asian Pac J Cancer Prev
September 2022
Department of Radiation Oncology, Kasturba Medical College (A Constituent Institution of Manipal Academy of Higher Education), Mangalore, Karnataka, India.
Background: The aim of this study is to design and fabricate a thorax phantom with irregularly shaped trapezoidal slots across the left side of the chest wall, allowing for the creation of unwanted air gaps under the bolus.
Method: Surface dose (Dsurf) measurements were made with Gaf Chromic EBT3 films at air gaps (0.0, 5.
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