Nueclear Web Banner
Journal of Medical Physics
 Home | Search | Ahead of print | Current Issue | Archives | Instructions | Subscription | Login  The official journal of Association of Medical Physicists of India      
 Users online: 357  Home  EMail this page Print this page Decrease font size Default font size Increase font size 
ORIGINAL ARTICLE
Year : 2017  |  Volume : 42  |  Issue : 3  |  Page : 116-122

A hybrid conformal planning technique with solitary dynamic portal for postmastectomy radiotherapy with regional nodes


Department of Radiotherapy, Christian Medical College, Vellore, Tamil Nadu, India

Correspondence Address:
K Mohamathu Rafic
Lecturer in Radiological Physics, Department of Radiotherapy, Christian Medical College, Vellore - 632 004, Tamil Nadu
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmp.JMP_3_17

Rights and Permissions

Purpose: This study focuses on incorporation of a solitary dynamic portal (SDP) in conformal planning for postmastectomy radiotherapy (PMRT) with nodal regions with an intention to overcome the treatment planning limitations imposed by conventional techniques. Materials and Methods: Twenty-four patients who underwent surgical mastectomy followed by PMRT were included in this study. Initially, a treatment plan comprising tangential beams fitted to beam's-eye-view (BEV) of chest wall (CW) and a direct anterior field fitted to BEV of nodal region, both sharing a single isocenter was generated using Eclipse treatment planning system. Multiple field-in-fields with optimum beam weights (5% per field) were added primarily from the medial tangent, fitted to BEV of entire target volume, and finally converted into a dynamic portal. Dosimetric analysis for the treatment plans and fluence verification for the dynamic portals were performed. Results and Discussion: Conformal plans with SDP showed excellent dose coverage (V95%>95%), higher degree of tumor dose conformity (≤1.25) and homogeneity (≤0.12) without compromising the organ at risk sparing for PMRT with nodal region. Treatment plans with SDP considerably reduced the lower isodose spread to the ipsilateral lung, heart, and healthy tissue without affecting the dose homogeneity. Further, gamma evaluation showed more than 96% pixel pass rate for standard 3%/3 mm dose difference and distance-to-agreement criteria. Moreover, this plan offers less probability of “geometrical miss” at the highly irregular CW with regional nodal radiotherapy. Conclusion: Hybrid conformal plans with SDP would facilitate improved dose distribution and reduced uncertainty in delivery and promises to be a suitable treatment option for complex postmastectomy CW with regional nodal irradiation.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed273    
    Printed3    
    Emailed0    
    PDF Downloaded41    
    Comments [Add]    

Recommend this journal