Journal of Medical Physics
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INVITED PAPER
Year : 2009  |  Volume : 34  |  Issue : 3  |  Page : 149-152

Technique alternatives for breast radiation oncology: Conventional radiation therapy to tomotherapy


Department of Radiation Oncology, Institut Curie, 26 rue d'Ulm, Paris 75005, France

Correspondence Address:
N Fournier-Bidoz
Department of Radiation Oncology, Institut Curie, 26 rue d'Ulm, Paris 75005
France
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-6203.54849

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Breast conserving radiotherapy uses tangential fields and compensating wedges. This conventional approach can be improved by a field-in-field technique using the linac multi-leaf collimator (MLC). A simplified field-in-field technique that planners can easily achieve and which improves dose uniformity in the breast volume is presented here. Field junction problems are more easily solved by the use of a virtual simulation. A unique isocenter can be set at the junction between the supra-clavicular field and the breast tangential fields. However, careful quality assurance of the treatment planning system must be performed. Tomotherapy has promising clinical advantages: the ability of a tomographic image to correct for random set-up errors, a continuous cranio-caudal delivery which suppresses junction problems, the conformality of the dose distribution throughout the complex volumes formed by the lymph nodes and the breasts. Tomotherapy is a valuable recourse for complex irradiations like bilateral breast or mammary plus axillary irradiation while a field-in-field associated with a unique isocenter technique can be used for majority of the patients.


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