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Review
. 2010;26(7):699-709.
doi: 10.3109/02656736.2010.493915.

Present and future technology for simultaneous superficial thermoradiotherapy of breast cancer

Eduardo G Moros  1 , Jose Peñagaricano, Petr Novàk, William L Straube, Robert J Myerson
Affiliations
Review

Present and future technology for simultaneous superficial thermoradiotherapy of breast cancer

Eduardo G Moros et al. Int J Hyperthermia. 2010.

Abstract

This paper reviews systems and techniques to deliver simultaneous thermoradiotherapy of breast cancer. It first covers the clinical implementation of simultaneous delivery of superficial (microwave or ultrasound) hyperthermia and external photon beam radiotherapy, first using a Cobalt-60 teletherapy unit and later medical linear accelerators. The parallel development and related studies of the Scanning Ultrasound Reflector Linear Arrays System (SURLAS), an advanced system specifically designed and developed for simultaneous thermoradiotherapy, follows. The performance characteristics of the SURLAS are reviewed and power limitation problems at high acoustic frequencies (>3 MHz) are discussed along with potential solutions. Next, the feasibility of simultaneous SURLAS hyperthermia and intensity modulated radiation therapy/image-guided radiotherapy (IMRT/IGRT) is established based on published and newly presented studies. Finally, based on the encouraging clinical results thus far, it is concluded that new trials employing the latest technologies are warranted along with further developments in treatment planning.

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Figures

Figure 1
Figure 1
Three dimensional model of the SURLAS applicator showing basic components.
Figure 2
Figure 2
Force balance results for the low (a) and high (b) frequency arrays. The three curves in each plot are for measurements for three different positions of the reflector with respect to an array. Distal was when the reflector was the furthest from then array in question and thus the ultrasound traveled the longest before reaching the force balance detector. Each data value was the average of five measurements. Standard deviations were too small to plot as error bars.
Figure 3
Figure 3
Twelve-beam IMRT plan dose distributions on the axial, sagittal and coronal planes through the PTV and SURLAS applicator. An MVCT of the RANDO phantom with the SURLAS on top simulating a typical clinical setup for the treatment of chest wall recurrence of breast cancer was used as the planning CT.
Figure 4
Figure 4
Dose volume histograms for the PTV and organs at risks for the treatment plan shown in Figure 3.
See this image and copyright information in PMC

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