Journal of Medical Physics
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ORIGINAL ARTICLE
Year : 2013  |  Volume : 38  |  Issue : 3  |  Page : 125-131

Forward-planned intensity modulated radiation therapy using a cobalt source: A dosimetric study in breast cancer


1 Medical Physics Unit, Fondazione di Ricerca e Cura "Giovanni Paolo II", UniversitÓ Cattolica del Sacro Cuore, Campobasso, Italy
2 Department of Radiotherapy, Mulago Hospital, Kampala, Uganda
3 Radiation Oncology Unit, Fondazione di Ricerca e Cura "Giovanni Paolo II", UniversitÓ Cattolica del Sacro Cuore, Campobasso, Italy
4 Department of Radiotherapy, Black Lion Hospital, Addis-Ababa, Ethiopia
5 Department of Radiotherapy, Radiotherapy and Oncology Centre, Abuth, Zaria, Nigeria
6 Department of Medical Physics, UniversitÓ Cattolica del Sacro Cuore, Roma, Italy
7 Department of Radiation Oncology, UniversitÓ Cattolica del Sacro Cuore, Roma, Italy
8 Radiation Oncology Unit, Fondazione di Ricerca e Cura "Giovanni Paolo II", UniversitÓ Cattolica del Sacro Cuore, Campobasso; Department of Radiation Oncology, UniversitÓ Cattolica del Sacro Cuore, Roma, Italy

Correspondence Address:
Savino Cilla
Medical Physics Unit, Fondazione di Ricerca e Cura "Giovanni Paolo II", UniversitÓ Cattolica del S. Cuore, Campobasso, Largo A. Gemelli 1, 86100 Campobasso
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-6203.116367

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This analysis evaluates the feasibility and dosimetric results of a simplified intensity-modulated radiotherapy (IMRT) treatment using a cobalt-therapy unit for post-operative breast cancer. Fourteen patients were included. Three plans per patient were produced by a cobalt-60 source: A standard plan with two wedged tangential beams, a standard tangential plan optimized without the use of wedges and a plan based on the forward-planned "field-in-field" IMRT technique (Co-FinF) where the dose on each of the two tangential beams was split into two different segments and the two segments weight was determined with an iterative process. For comparison purposes, a 6-MV photon standard wedged tangential treatment plan was generated. D mean , D 98% , D 2% , V 95% , V 107%, homogeneity, and conformity indices were chosen as parameters for comparison. Co-FinF technique improved the planning target volume dose homogeneity compared to other cobalt-based techniques and reduced maximum doses (D 2% ) and high-dose volume (V 110% ). Moreover, it showed a better lung and heart dose sparing with respect to the standard approach. The higher dose homogeneity may encourage the adoption of accelerated-hypofractionated treatments also with the cobalt sources. This approach can promote the spread of breast conservative treatment in developing countries.


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