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ABSTRACT: Radiotherapy can induce tissue reactions with an edema leading to increased breast volume. The aim of the present study was to quantify this increase and analyze its effect on the electron boost technique.
140 patients with breast cancer treated with breast-conserving surgery underwent CT planning before, during and/or after radiotherapy in order to evaluate breast volume changes due to radiotherapy. CT data were analyzed using the HELAX planning system and dose distribution was assessed. Determination of the breast volume was achieved using an interpolation algorithm. Three subgroups were analyzed: group 1 (n = 47): < or = 670 cm(3), group 2 (n = 46): 671-999 cm(3), and group 3 (n = 47): > or = 1000 cm(3) breast volume.
The mean initial breast volume was 907 cm(3) (100-3073 cm(3)). After radiotherapy, mean breast volume increased by 81 cm(3) to 988 cm(3) (109-3185 cm(3)). Significant changes in volume were observed after a dose of 40 Gy. According to the subgroups mean volume increase was as follows: group 1: 53 cm(3) (3-120 cm(3)), group 2: 85 cm(3) (20-200 cm(3)), and group 3: 105 cm(3) (5-340 cm(3)). This difference was statistically significant for all subgroups (p < 0.001). Corresponding to the volume increase, depth of the boost target volume changed up to 1.0 cm.
As radiotherapy may lead to a significant increase in breast volume, it seems appropriate to perform a second planning CT after about 40 Gy in order to optimize dose distribution for boost irradiation.
Strahlentherapie und Onkologie 04/2005; 181(4):255-9. · 3.56 Impact Factor
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ABSTRACT: Hintergrund und Ziel:
Eine Radiotherapie der Mamma induziert eine Gewebereaktion mit daraus resultierendem dem. Dieses dem fhrt zu einer Volumenzunahme der Mamma. Ziel der Studie war es, diese Volumenzunahme zu quantifizieren und deren Einfluss auf die Planung des Elektronenboosts zu analysieren.
Patienten und Methodik:
Bei 140 Patientinnen mit Mammakarzinom nach brusterhaltender Therapie erfolgte vor, whrend und/oder nach der Bestrahlung eine CT-Planung, um die Volumenvernderungen whrend der Bestrahlung zu evaluieren. Die ermittelten CT-Daten wurden unter Verwendung des HELAX-TMS-Planungssystems zur Bestimmung der Dosisverteilung ausgewertet. Die Bestimmung des Brustvolumens erfolgte mittels Interpolationsalgorithmus. Gemessen am Ausgangsvolumen wurden die Patientinnen in drei Subgruppen unterteilt: Gruppe 1 (n = 47): 670 cm3, Gruppe 2 (n = 46): 671–999 cm3 und Gruppe 3 (n = 47): 1 000 cm3 Brustvolumen.
Ergebnisse:
Initial zeigte sich ein mittleres Brustvolumen von 907 cm3 (100–3 073 cm3). Nach Radiotherapie kam es zu einem Anstieg des Brustvolumens um durchschnittlich 81 cm3 auf 988 cm3 (109–3 185 cm3). Signifikant messbare Volumenzunahmen traten ab einer Zielvolumendosis von 40 Gy auf. Bezogen auf die drei Subgruppen ergaben sich folgende mittlere Volumenzunahmen: Gruppe 1: 53 cm3 (3–120 cm3), Gruppe 2: 85 cm3 (20–200 cm3) und Gruppe 3: 105 cm3 (5–340 cm3). Der Zuwachs war in allen drei Gruppen mit einem p-Wert von p < 0,001="" hochsignifikant.="" je="" nach="" volumenzunahme="" der="" brust="" resultierte="" eine="" nderung="" der="" herdtiefe="" um="" bis="" zu="" 1,0="">
Schlussfolgerung:
Aufgrund der interkurrenten Volumennderungen unter Bestrahlung erscheint eine zweite CT-Untersuchung zur Nachplanung vor Boostbestrahlung sinnvoll. Die zweite CT-Planung sollte ab 40 Gy erfolgen, um das dem ausreichend erfassen zu knnen.
Background and Purpose:
Radiotherapy can induce tissue reactions with an edema leading to increased breast volume. The aim of the present study was to quantify this increase and analyze its effect on the electron boost technique.
Patients and Methods:
140 patients with breast cancer treated with breast-conserving surgery underwent CT planning before, during and/or after radiotherapy in order to evaluate breast volume changes due to radiotherapy. CT data were analyzed using the HELAX planning system and dose distribution was assessed. Determination of the breast volume was achieved using an interpolation algorithm. Three subgroups were analyzed: group 1 (n = 47): 670 cm3, group 2 (n = 46): 671–999 cm3, and group 3 (n = 47): 1000 cm3 breast volume.
Results:
The mean initial breast volume was 907 cm3 (100–3073 cm3). After radiotherapy, mean breast volume increased by 81 cm3 to 988 cm3 (109–3185 cm3). Significant changes in volume were observed after a dose of 40 Gy. According to the subgroups mean volume increase was as follows: group 1: 53 cm3 (3–120 cm3), group 2: 85 cm3 (20–200 cm3), and group 3: 105 cm3 (5–340 cm3). This difference was statistically significant for all subgroups (p < 0.001).="" corresponding="" to="" the="" volume="" increase,="" depth="" of="" the="" boost="" target="" volume="" changed="" up="" to="" 1.0="">
Conclusion:
As radiotherapy may lead to a significant increase in breast volume, it seems appropriate to perform a second planning CT after about 40 Gy in order to optimize dose distribution for boost irradiation.
Strahlentherapie und Onkologie 03/2005; 181(4):255-259. · 3.56 Impact Factor
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ABSTRACT: Implementation of an important step for quality assurance in irradiation of the craniospinal axis was made through changes in the irradiation technique. Crucial improvements in patient positioning and the possibility of taking portal films of the field junctions are described.
A box for the positioning of the head of the patient in has been developed. In combination with vacuum cushions, it is a cheap method for the individual and secure positioning of the patient in prone position. Furthermore, a method for taking portal films of the field junctions between the lateral cranial and the upper dorsal spinal field as well as between the two dorsal spinal fields is described.
The use of the "Bonner Box" improves the patient positioning with respect to reproducibility, setup time and comfort. The documentation of the field junctions in craniospinal irradiation, which is described for the first time, is an important tool for quality assurance.
Strahlentherapie und Onkologie 02/2003; 179(1):50-3. · 3.56 Impact Factor
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ABSTRACT: Hintergrund: Die Verbesserung der Technik sowohl hinsichtlich der Reproduzierbarkeit der Patientenlagerung als auch der Verifikation der Feldanschlsse stellt einen entscheidenden Schritt zur Qualittssicherung bei der Bestrahlung der kraniospinalen Achse dar. Material und Methode: Zur Lagerung des Kopfes bei der Bestrahlung der kraniospinalen Achse wurde eine Box entwickelt. In Kombination mit einer Krperlagerung auf Vakuumkissen handelt es sich um eine kostengnstige Methode zur individuellen und sicheren Positionierung des Patienten in Bauchlage. Weiterhin wird eine Methode zur Verifikation der Feldanschlsse zwischen seitlichen Zerebralfeldern und kranialem Wirbelsulenfeld und zwischen den zumeist notwendigen Wirbelsulenfeldern vorgestellt. Diskussion: Durch die Verwendung der vorgestellten Lagerungshilfe wird die Patientenlagerung hinsichtlich Reproduzierbarkeit, Vorbereitungszeit und Bequemlichkeit deutlich verbessert. Die ermglichte Verifikation der Feldanschlsse bei der Bestrahlung der kraniospinalen Achse stellt ebenfalls einen wichtigen Beitrag zur Qualttssicherung dar. Background: Implementation of an important step for quality assurance in irradiation of the craniospinal axis was made through changes in the irradiation technique. Crucial improvements in patient positioning and the possibility of taking portal films of the field junctions are described. Material and Methods: A box for the positioning of the head of the patient in has been developed. In combination with vacuum cushions, it is a cheap method for the individual and secure positioning of the patient in prone position. Furthermore, a method for taking portal films of the field junctions between the lateral cranial and the upper dorsal spinal field as well as between the two dorsal spinal fields is described. Discussion: The use of the "Bonner Box" improves the patient positioning with respect to reproducibility, setup time and comfort. The documentation of the field junctions in craniospinal irradiation, which is described for the first time, is an important tool for quality assurance.
Strahlentherapie und Onkologie 12/2002; 179(1):50-53. · 3.56 Impact Factor
