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. 2013 Jul;38(3):125-31.
doi: 10.4103/0971-6203.116367.

Forward-planned intensity modulated radiation therapy using a cobalt source: A dosimetric study in breast cancer

Savino Cilla  1 , Joseph Kigula-Mugambe, Cinzia Digesù, Gabriella Macchia, Solomon Bogale, Mariangela Massaccesi, David Dawotola, Francesco Deodato, Milly Buwenge, Luciana Caravatta, Angelo Piermattei, Vincenzo Valentini, Alessio G Morganti
Affiliations

Forward-planned intensity modulated radiation therapy using a cobalt source: A dosimetric study in breast cancer

Savino Cilla et al. J Med Phys. 2013 Jul.

Abstract

This analysis evaluates the feasibility and dosimetric results of a simplified intensity-modulated radiotherapy (IMRT) treatment using a cobalt-therapy unit for post-operative breast cancer. Fourteen patients were included. Three plans per patient were produced by a cobalt-60 source: A standard plan with two wedged tangential beams, a standard tangential plan optimized without the use of wedges and a plan based on the forward-planned "field-in-field" IMRT technique (Co-FinF) where the dose on each of the two tangential beams was split into two different segments and the two segments weight was determined with an iterative process. For comparison purposes, a 6-MV photon standard wedged tangential treatment plan was generated. Dmean, D98%, D2%, V95%, V107%, homogeneity, and conformity indices were chosen as parameters for comparison. Co-FinF technique improved the planning target volume dose homogeneity compared to other cobalt-based techniques and reduced maximum doses (D2%) and high-dose volume (V110%). Moreover, it showed a better lung and heart dose sparing with respect to the standard approach. The higher dose homogeneity may encourage the adoption of accelerated-hypofractionated treatments also with the cobalt sources. This approach can promote the spread of breast conservative treatment in developing countries.

Keywords: Breast neoplasms; cobalt machine; intensity-modulated radiotherapy; radiotherapy.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Medial beam's-eye view of (a) main field and (b) subfield used in FinF technique for a representative patient
Figure 2
Figure 2
Planning target volume box-and-whisker plot of (a) minimum dose (D98%), (b) mean dose (Dmean), (c) percentage volume receiving more than 110% of the prescribed dose (V110%), (d) maximum dose (D2%), (e) homogeneity index, and (f) conformity index for the four techniques
Figure 3
Figure 3
Dose distribution (V95%, green; V105%, yellow; V110%, orange and V115%, red) for (a) Co-OF, (b) Co-WF, (c) Co-FinF and (d) 6MV-conformal radiotherapy on the axial and coronal plane containing isocenter
See this image and copyright information in PMC

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References

    1. Boyle P, Howell A. The globalisation of breast cancer. Breast Cancer Res. 2010;12:S7. - PMC - PubMed
    1. Akarolo-Anthony SN, Ogundiran TO, Adebamowo CA. Emerging breast cancer epidemic: Evidence from Africa. Breast Cancer Res. 2010;12:S8. - PMC - PubMed
    1. Bese NS, Munshi A, Budrukkar A, Elzawawy A, Perez CA Breast Health Global Initiative Radiation Therapy Focus Group. Breast radiation therapy guideline implementation in low- and middle-income countries. Cancer. 2008;113:2305–14. - PubMed
    1. Hurkmans CW, Meijer GJ, van Vliet-Vroegindeweij C, van der Sangen MJ, Cassee J. High-dose simultaneously integrated breast boost using intensity-modulated radiotherapy and inverse optimization. Int J Radiat Oncol Biol Phys. 2006;66:923–30. - PubMed
    1. Singla R, King S, Albuquerque K, Creech S, Dogan N. Simultaneous-integrated boost intensity-modulated radiation therapy (SIB-IMRT) in the treatment of early-stage left-sided breast carcinoma. Med Dosim. 2006;31:190–6. - PubMed