• Journal of radiological science and technology
• /
• v.35 no.3
• /
• pp.249-254
• /
• 2012

The aim of this study was to investigate the setup accuracy for tangential breast treatment patients using electronic portal image and 2-D reconstruction image Twenty two patients undergoing tangential breast treatment. To explore the setup accuracy, distances between chosen landmarks were taken as reference parameters. The difference between measured reference parameters on simulation films and electronic portal images (EPIs) was calculated as the setup error. A total of 22 simulation films and 110 EPIs were evaluated. In the tangential fields, the calculated reference parameters were the central lung distance (CLD), central soft-tissue distance (CSTD), and above lung distance (ALD), below lung distance (BLD). In the medial tangential field, the average difference values for these parameters were 1.0, -6.4, -2.1 and 2.0, respectively; and the ${\sigma}$ values were 1.5, 2.3, 4.1 and 1.1, respectively. In the lateral tangential field, the average difference values for these parameters were -1.5, -4.3, -2.7 and -1.3, respectively; and the ${\sigma}$ values were 3.3, 2.1, 2.9 and 2.5, respectively. CLD, CSTD, ALD and BLD in the tangential fields are easily identifiable and are helpful for detecting setup errors using EPIs in patients undergoing tangential breast radiotherapy treatment.

• The Journal of Korean Society for Radiation Therapy
• /
• v.24 no.2
• /
• pp.183-188
• /
• 2012

Purpose: The concern of improving the quality of life and reducing side effects related to cancer treatment has been a subject of interest in recent years with advances in cancer treatment techniques and increasing survival time. This study is an analysis of differing scattered dose to the contralateral breast using common different treatment techniques. Materials and Methods: Eclipse 10.0 (Varian, USA) based $30^{\circ}$ EDW (Enhanced dynamic wedge) plan, $15^{\circ}$ wedge plan, $30^{\circ}$ wedge plan, Open beam plan, FiF (field in field) plan were established using CT image of breast phantom which in our hospital. Each treatment plan were designed to exposure 400 cGy using CL-6EX (VARIAN, USA) and we measured scattered dose at 1 cm, 3 cm, 5 cm, 9 cm away from medial side of the phantom at 1 cm depth using ionization chamber (FC 65G, IBA). We carried out measurement by separating effect of medial tangential field and lateral tangential field and analyze. Results: The evaluation of scattered dose to contralateral breast, $30^{\circ}$ EDW plan, $15^{\circ}$ wedge plan, $30^{\circ}$ wedge plan, Open beam plan, FIF plan showed 6.55%, 4.72%, 2.79%, 2.33%, 1.87% about prescription dose of each treatment plan. The result of scattered dose measurement by separating effect of medial tangential field and lateral tangential field results were 4.94%, 3.33%, 1.55%, 1.17%, 0.77% about prescription dose at medial tangential field and 1.61%, 1.40%, 1.24%, 1.16%, 1.10% at lateral tangential field along with measured distance. Conclusion: In our experiment, FiF treatment technique generates minimum of scattered dose to contralateral breast which come from mainly phantom scatter factor. Whereas $30^{\circ}$ wedge plan generates maximum of scattered doses to contralateral breast and 3.3% of them was scattered from gantry head. The description of treatment planning system showed a loss of precision for a relatively low scatter dose region. Scattered dose out of Treatment radiation field is relatively lower than prescription dose but, in decision of radiation therapy, it cannot be ignored that doses to contralateral breast are related with probability of secondary cancer.

• Journal of Magnetics
• /
• v.21 no.1
• /
• pp.133-140
• /
• 2016

In this study the contralateral breast skin dose was decreased. It was to apply the results to the clinical study after analysis of different radiation dose amounts to contralateral breast with nonmagnetic bolus and without nonmagnetic bolus. A Rando phantom was computed tomography (CT) simulated, five treatment plans were generated: open tangents, open field in field, wedge 15, wedge 30, and intensity-modulated radiotherapy (IMRT) plan with 50.4 Gy to cover sufficient breast tissue. Contralateral breast skin dose was measured at 8 points using a glass dosimeter. The average contralateral breast dose using nonmagnetic bolus showed better excellence in decreasing the absorbed dose in the order of $168{\pm}11.1$ cGy, $131{\pm}10.2$ cGy (29%), $112{\pm}9.7$ cGy (49%), and $102{\pm}9.5$ cGy (64%) than changing the treatment plan. This study focused on decreasing the effect of scattered dose by use of a nonmagnetic bolus on the contralateral breast during radiotherapy in breast cancer patients and an intriguingly significant decrease was observed parallel to the opposed beam.

• Progress in Medical Physics
• /
• v.18 no.3
• /
• pp.167-171
• /
• 2007

In the case of radiotherapy following breast conservation therapy for breast cancer patients, the characteristic of skin dose was investigated in the treatment of intensity modulated radiation therapy (IMRT) for breast cancer patients by comparing and analysing entrance skin dose irradiated during radiotherapy using tangential technique radiotherpy, and IMRT. The calculation dose irradiated to breast skin was compared with TLD measurement dose in treatment planning by performing the two methods of radiotherapy using tangential technique, and IMRT in treatment planning equipment. The skin absorbed dose was measured to pass a nipple by spacing of 1 cm distance from center to edge of body. In the radiotherapy of tangential technique, for the irradiation of 180 cGy to PTV, the calculation dose was ranged from 103.5 cGy to 155.2 cGy, measurement dose was ranged from 107.5 cGy to 156.2 cGy, and skin dose in the center was maximum 1.45 times more irradiated than that in the edge. In the IMRT, for the irradiation of 180 cGy to PTV, the calculation dose was ranged 9.8 cGy at 80.2 cGy, measurement dose was ranged 8.9 cGy at 77.2 cGy, and skin dose in the center was maximum 0.23 times less irradiated than that in the edge. IMRT was more effective for skin radiation risks because radiation dose irradiated to skin in IMRT was much less than that in radiotherapy of tangential field technique.

• Progress in Medical Physics
• /
• v.3 no.2
• /
• pp.59-65
• /
• 1992

Carcimoma of the breast are first frequency malignancy in women in the world. third frequency in Korea. Radiation therapy in breast cancer were treated through opposed tangential fields with photon beam or electron beam. Density within the field and thickness to tumor are very importent factors determining dose distribution in radiation therapy of electron beam. Radiotherapy traetment planning using computed tomography in Breast cancer are able to ideal dose distribution. Authors concluded as following. 6MeV energy of electron beam propered below 1.5cm in chest wall's thickness or internal mammary lymphnode's depth. 9MeV energy of electron beam from 1.5cm to 2.0cm. 12 MeV energy of electron beam from 2.0cm to 2.5cm.

• The Journal of Korean Society for Radiation Therapy
• /
• v.6 no.1
• /
• pp.67-70
• /
• 1994

The use of primary breast irraditation with advantage of improved cosmesis in breast cancer may be the potential risks of radiation for a change in the number of normal breast cancers and lung fibrosis. The magnitude of the scattered dose for a variety of radiation treatment techniques from patient of breast cancer and phantom was measured by adequate dosimeters. We can reduce the dose of the normal breast to treated with radiation by understanding the factors contributing to the unwanted dose and by determining ways to decrease this dose.

• The Journal of Korean Society for Radiation Therapy
• /
• v.27 no.2
• /
• pp.175-181
• /
• 2015

Purpose : To evaluate Contralateral Breast Doses with Supine and Prone Positions for tangential Irradiation techniques for left-sided breast Cancer Materials and Methods : We performed measurements for contralateral doses using Human Phantom at each other three plans (conventional technique, Field-in-Field, IMRT, with prescription of 50 Gy/25fx). For the measurement of contralateral doses we used Glass dosimeters on the 4 points of Human Phantom surface (0 mm, 10 mm, 30 mm, 50 mm). For the position check at every measurements, we had taken portal images using EPID and denoted the incident points on the human phantom for checking the constancy of incident points. Results : The contralateral doses in supine position showed a little higher doses than those in prone position. In the planning study, contralateral doses in the prone position increased mean doses of 1.2% to 1.8% at each positions while those in the supine positions showed mean dose decreases of 0.8% to 0.9%. The measurements using glass dosimeters resulted in dose increases (mean: 2.7%, maximum: 4% of the prescribed dose) in the prone position. In addition, the delivery techniques of Field-in-field and IMRT showed mean doses of 3% higher than conventional technique. Conclusion : We evaluated contralateral breast doses depending on different positions of supine and prone for tangential irradiations. For the phantom simulation of set-up variation effects on contralateral dose evaluation, although we used humanoid phantom for planning and measurements comparisons, it would be more or less worse set-up constancy in a real patient. Therefore, more careful selection of determination of patient set-up for the breast tangential irradiation, especially in the left-sided breast, should be considered for unwanted dose increases to left lung and heart. In conclusion, intensive patient monitoring and improved patient set-up verification efforts should be necessary for the application of prone position for tangential irradiation of left-sided breast cancer.

• The Journal of Korean Society for Radiation Therapy
• /
• v.1 no.1
• /
• pp.37-42
• /
• 1985

Radiation Therapy(RT) has been used in the treatment of breast cancer for over 80 years. Technically, it should include a part or all of such areas as chest wall or breast, axilla, internal mammary nodes(IM) and supraclavicular nodes (SCL). Authors tried three-field technique for the treatment of breast cancer using 6 MV linear accelerator, exclusively the department of Radiology, Kang-Nam St. Mary's Hospital, at Catholic Medical College. The field junction was checked by a phantom study and radiation doses measured by film densitometry and TLD. The 3 fields we used in this study were two isocentric opposing tangential fields encompassing the breast, chest wall and occasionally IM and one single anterior field encompassing the axilla and SCL. Using appropriate beam blocks and blouses, we were able to avoid unwanted intrinsic divergency of photon beam. Blocking also enabled us to set-up precise radiation field with ease.

• Radiation Oncology Journal
• /
• v.2 no.2
• /
• pp.303-309
• /
• 1984

Radiation therapy(RT) has been used in the treatment of breast cancer for over 80years. Technically, it should include a part or all of such areas as chest wall or breast, axilla, internal mammary nodes (IM) and supraclavicular nodes (SCL). Authors tried three-field technique for the treatment of breast cancer using 6-MV linear accelerator, exclusively the department of radiology. Kang-Nam St. Mary's Hospital, at Catholic Medical College. The field junction was checked by a Phantom study and radiation doses measured by film densitometry and TLD. The 3 fields we used in this study were two isocentric opposing tangential fields encompassing the breast, chest wall and occasionally IM and one single anterior field encompassing the axilla and SCL. sing appropriate beam blocks and boluses, we were able to avoid unwanted intrinsic divergency of photon beam. Blocking also enabled us to set-up precise radiation field with ease.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.17
• /
• pp.7785-7788
• /
• 2015

Utilization of high energy photons (>10MV) with an optimal weight using a mixed energy technique is a practical way to generate a homogenous dose distribution while maintaining adequate target coverage in intact breast radiotherapy. This study represents a model for estimation of this optimal weight for day to day clinical usage. For this purpose, treatment planning computed tomography scans of thirty-three consecutive early stage breast cancer patients following breast conservation surgery were analyzed. After delineation of the breast clinical target volume (CTV) and placing opposed wedge paired isocenteric tangential portals, dosimeteric calculations were conducted and dose volume histograms (DVHs) were generated, first with pure 6MV photons and then these calculations were repeated ten times with incorporating 18MV photons (ten percent increase in weight per step) in each individual patient. For each calculation two indexes including maximum dose in the breast CTV ($D_{max}$) and the volume of CTV which covered with 95% Isodose line ($V_{CTV,95%IDL}$) were measured according to the DVH data and then normalized values were plotted in a graph. The optimal weight of 18MV photons was defined as the intersection point of $D_{max}$ and $V_{CTV,95%IDL}$ graphs. For creating a model to predict this optimal weight multiple linear regression analysis was used based on some of the breast and tangential field parameters. The best fitting model for prediction of 18MV photons optimal weight in breast radiotherapy using mixed energy technique, incorporated chest wall separation plus central lung distance (Adjusted R2=0.776). In conclusion, this study represents a model for the estimation of optimal beam weighting in breast radiotherapy using mixed photon energy technique for routine day to day clinical usage.