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dc.contributor.authorJain, Pooja
dc.contributor.authorMarchant, Thomas E
dc.contributor.authorGreen, Melanie M
dc.contributor.authorWatkins, Gillian R
dc.contributor.authorDavies, Julie
dc.contributor.authorMcCarthy, Claire
dc.contributor.authorLoncaster, Juliette A
dc.contributor.authorStewart, Alan L
dc.contributor.authorMagee, Brian
dc.contributor.authorMoore, Christopher J
dc.contributor.authorPrice, Patricia M
dc.date.accessioned2009-06-04T14:36:05Z
dc.date.available2009-06-04T14:36:05Z
dc.date.issued2009-01
dc.identifier.citationInter-fraction motion and dosimetric consequences during breast intensity-modulated radiotherapy (IMRT). 2009, 90 (1):93-8 Radiother Oncolen
dc.identifier.issn0167-8140
dc.identifier.pmid19012980
dc.identifier.doi10.1016/j.radonc.2008.10.010
dc.identifier.urihttp://hdl.handle.net/10541/69736
dc.description.abstractBACKGROUND 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.
dc.language.isoenen
dc.subjectBreast Canceren
dc.subject.meshBreast Neoplasms
dc.subject.meshFemale
dc.subject.meshHumans
dc.subject.meshLinear Models
dc.subject.meshMotion
dc.subject.meshPosture
dc.subject.meshProspective Studies
dc.subject.meshRadiography, Interventional
dc.subject.meshRadiotherapy Dosage
dc.subject.meshRadiotherapy Planning, Computer-Assisted
dc.subject.meshRadiotherapy, Intensity-Modulated
dc.subject.meshTomography, X-Ray Computed
dc.subject.meshTreatment Outcome
dc.titleInter-fraction motion and dosimetric consequences during breast intensity-modulated radiotherapy (IMRT).en
dc.typeArticleen
dc.contributor.departmentAcademic Department of Radiation Oncology, The University of Manchester, Manchester M20 4BX, UK.en
dc.identifier.journalRadiotherapy and Oncologyen
html.description.abstractBACKGROUND 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.


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