Evaluation of surface dose outside the treatment area for five breast cancer irradiation modalities using thermo-luminescent dosimeters

Purpose: To measure and compare the surface dose outside the treatment area at six different points of interest (POIs) for five different breast cancer radiation treatment modalities by using thermo-luminescent dosimeters (TLDs). This experiment will evaluate the magnitude of the dose due to scatter and leakage radiation at different areas outside the target on a patient that could potentially lead, in the long term, to radiation induced secondary malignancies.Methods: TLD-100 were calibrated according to the University of Wisconsin Radiation Calibration Laboratory protocol and then used for dose measurements at selected POIs namely sternum, lower abdomen, contralateral breast, thyroid, shoulder, and eye. Twenty five breast cancer patients and the following modalities were included in this study: Strut-adjusted volume implant (SAVI), mammosite multi-lumen (ML), Accuboost, electron boost and photon boost. The surface doses in all patients were measured in a single fraction. The delivered target doses were normalized to 200 cGy. Finally, breast quadrant analysis was performed.Results: The maximum average dose for each POI was as follows: Sternum 6.51 cGy (SD 2.93), lower abdomen 4.50 cGy (SD 2.63), contralateral breast 8.52 cGy (SD 3.86), thyroid 5.50 cGy (SD 2.75), shoulder 5.58 cGy (SD 2.77), and eye 2.65 cGy (SD 0.68). The highest POI dose of 15.84 cGy was found in contralateral breast.Conclusion: The measured surface dose at each POI varies with the modality of treatment. The surface doses show a strong correlation to the tumor bed location in the breast quadrant. The SAVI, electron boost, and photon boost modalities had delivered smaller surface dose at POIs than the Accuboost and Mammosite ML modalities. While the measured doses fall within the low range, its significance in producing second malignancies would require a large cohort of patients and a longer follow up

Evaluation of surface dose outside the treatment area for five breast cancer irradiation modalities using thermo-luminescent dosimeters

Purpose: To measure and compare the surface dose outside the treatment area at six different points of interest (POIs) for five different breast cancer radiation treatment modalities by using thermo-luminescent dosimeters (TLDs). This experiment will evaluate the magnitude of the dose due to scatter and leakage radiation at different areas outside the target on a patient that could potentially lead, in the long term, to radiation induced secondary malignancies.Methods: TLD-100 were calibrated according to the University of Wisconsin Radiation Calibration Laboratory protocol and then used for dose measurements at selected POIs namely sternum, lower abdomen, contralateral breast, thyroid, shoulder, and eye. Twenty five breast cancer patients and the following modalities were included in this study: Strut-adjusted volume implant (SAVI), mammosite multi-lumen (ML), Accuboost, electron boost and photon boost. The surface doses in all patients were measured in a single fraction. The delivered target doses were normalized to 200 cGy. Finally, breast quadrant analysis was performed.Results: The maximum average dose for each POI was as follows: Sternum 6.51 cGy (SD 2.93), lower abdomen 4.50 cGy (SD 2.63), contralateral breast 8.52 cGy (SD 3.86), thyroid 5.50 cGy (SD 2.75), shoulder 5.58 cGy (SD 2.77), and eye 2.65 cGy (SD 0.68). The highest POI dose of 15.84 cGy was found in contralateral breast.Conclusion: The measured surface dose at each POI varies with the modality of treatment. The surface doses show a strong correlation to the tumor bed location in the breast quadrant. The SAVI, electron boost, and photon boost modalities had delivered smaller surface dose at POIs than the Accuboost and Mammosite ML modalities. While the measured doses fall within the low range, its significance in producing second malignancies would require a large cohort of patients and a longer follow up.</p

AAPM TG 236 Report 236: Recommendations on volume-image-based treatment planning, dosimetry, and quality management for HDR intracavitary brachytherapy: Part I breast

This is a zipped file for Appendix A.1 DVH validation using reference DCIOM datasets for AAPM TG report 236: Part I. Intracavitary breast brachytherapy. One can download and unzip the file. These are CT images and a structure file in DICOM format to validate the DVH information in your HDR brachytherapy treatment planning system either Varian BrachyVision or Elekta Oncentra. One can import all the DICOM files into your brachytherapy TPS and compute the dose. One can follow the instruction described in detail in Appendix A.1 of the AAPM TG 236: Part I report