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    Inter-fraction motion and dosimetric consequences during breast intensity-modulated radiotherapy (IMRT).

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    Authors
    Jain, Pooja
    Marchant, Thomas E
    Green, Melanie M
    Watkins, Gillian R
    Davies, Julie
    McCarthy, Claire
    Loncaster, Juliette A
    Stewart, Alan L
    Magee, Brian
    Moore, Christopher J
    Price, Patricia M
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    Affiliation
    Academic Department of Radiation Oncology, The University of Manchester, Manchester M20 4BX, UK.
    Issue Date
    2009-01
    
    Metadata
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    Abstract
    BACKGROUND AND PURPOSE: Intensity-modulated radiotherapy (IMRT) can improve dose homogeneity within the breast planned target volume (PTV), but may be more susceptible to patient/organ motion than standard tangential radiotherapy (RT). We used daily cone-beam CT (CBCT) imaging to assess inter-fraction motion during breast IMRT and its subsequent impact on IMRT and standard RT dose homogeneity. MATERIALS AND METHODS: Ten breast cancer patients selected for IMRT were studied. CBCT images were acquired immediately after daily treatment. Automatic image co-registration was used to determine patient positioning variations. Daily PTV contours were used to calculate PTV variations and daily delivered IMRT and theoretically planned tangential RT dose. RESULTS: Group systematic (and random) setup errors detected by CBCT were 5.7 (3.9)mm laterally, 2.8 (3.5)mm vertically and 2.3 (3.2)mm longitudinally. Rotations >2 degrees in any axis occurred on 53/106 (50%) occasions. Daily PTV volume varied up to 23%. IMRT dose homogeneity was superior at planning and throughout the treatment compared with standard RT (1.8% vs. 15.8% PTV received >105% planned mean dose), despite increased motion sensitivity. CONCLUSIONS: CBCT revealed inadequacies of current patient positioning and verification procedures during breast RT and confirmed improved dose homogeneity using IMRT for the patients studied.
    Citation
    Inter-fraction motion and dosimetric consequences during breast intensity-modulated radiotherapy (IMRT). 2009, 90 (1):93-8 Radiother Oncol
    Journal
    Radiotherapy and Oncology
    URI
    http://hdl.handle.net/10541/69736
    DOI
    10.1016/j.radonc.2008.10.010
    PubMed ID
    19012980
    Type
    Article
    Language
    en
    ISSN
    0167-8140
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.radonc.2008.10.010
    Scopus Count
    Collections
    All Christie Publications
    Christie Medical Physics and Engineering Research
    Clinical Oncology
    Academic Department of Radiation Oncology - ADRO

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