TY - JOUR
T1 - Improved treatment of the breast and supraclavicular fossa based on a simple geometrical principle
AU - Yavetz, Dalia
AU - Corn, Benjamin W.
AU - Matceyevsky, Diana
AU - Ben-Josef, Rahamim
AU - Soyfer, Viacheslav
AU - Bershtein, Igal
AU - Inbar, Moshe
AU - Ron, Ilan
AU - Jiveliouk, Irena
AU - Schifter, Dan
PY - 2011
Y1 - 2011
N2 - In breast cancer, nodal irradiation has become routine, but adds time and creates concerns for field overlap if the "match" is not accurate. We developed a technique to address these issues by using only one isocenter for both areas. Tangents are designed at simulation. The isocenter is then shifted to the upper border of the breast using a straightforward geometrical calculation. After determining the new isocenter, fields are recreated wherein the tangents are treated with a quarter beam and the supraclavicular field fashioned with a half-beam block. The gantry, collimator, and couch angles of the supraclavicular field are adjusted to achieve an accurate match. Ten patients were evaluated. Doses to the spinal cord and brachial plexus were lowered relative to conventional techniques. The hot spots were not augmented. In comparison with standard arrangements, setup time decreased. Accurate matching was consistently achieved and verified by portal imaging. A new approach for treating the supraclavicular fossa is easily executed. Advantages include negligible doses to the critical neural structures (i.e., spinal cord and brachial plexus), optimized matchline, and reduced setup time.
AB - In breast cancer, nodal irradiation has become routine, but adds time and creates concerns for field overlap if the "match" is not accurate. We developed a technique to address these issues by using only one isocenter for both areas. Tangents are designed at simulation. The isocenter is then shifted to the upper border of the breast using a straightforward geometrical calculation. After determining the new isocenter, fields are recreated wherein the tangents are treated with a quarter beam and the supraclavicular field fashioned with a half-beam block. The gantry, collimator, and couch angles of the supraclavicular field are adjusted to achieve an accurate match. Ten patients were evaluated. Doses to the spinal cord and brachial plexus were lowered relative to conventional techniques. The hot spots were not augmented. In comparison with standard arrangements, setup time decreased. Accurate matching was consistently achieved and verified by portal imaging. A new approach for treating the supraclavicular fossa is easily executed. Advantages include negligible doses to the critical neural structures (i.e., spinal cord and brachial plexus), optimized matchline, and reduced setup time.
KW - Breast
KW - Geometrical technique
KW - Supraclavicular fossa
UR - http://www.scopus.com/inward/record.url?scp=80755189064&partnerID=8YFLogxK
U2 - 10.1016/j.meddos.2010.11.001
DO - 10.1016/j.meddos.2010.11.001
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C2 - 21397491
AN - SCOPUS:80755189064
SN - 0958-3947
VL - 36
SP - 434
EP - 439
JO - Medical Dosimetry
JF - Medical Dosimetry
IS - 4
ER -