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Title
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Should we use RapidArc (VMAT) for breast radiotherapy? A Dosimetric comparison of IMRT versus VMAT optimization.
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Creator
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Moshiri Sedeh, Nader, Pella, Silvia, Leventouri, Theodora, Graduate College
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Abstract/Description
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Purpose: The purpose of this study is to compare the dose-volumetric results of intensity modulated radiation therapy (IMRT) with RapidArc (RA Varian Medical Systems, Palo Alto, CA) for whole breast irradiation. Methods: 25 patients previously treated for whole left breast (either RapidArc plan or IMRT) were the subjects of this planning study. Eclipse v 11.0.47 was used to make all retrospective plans using the same contours, energy, machine and normalization. Prescription dose to the...
Show morePurpose: The purpose of this study is to compare the dose-volumetric results of intensity modulated radiation therapy (IMRT) with RapidArc (RA Varian Medical Systems, Palo Alto, CA) for whole breast irradiation. Methods: 25 patients previously treated for whole left breast (either RapidArc plan or IMRT) were the subjects of this planning study. Eclipse v 11.0.47 was used to make all retrospective plans using the same contours, energy, machine and normalization. Prescription dose to the planning target volume was 5000 Gy in 25 fractions. All plans were normalized such that 100% covered 95% of planning target volume (PTV). Results: V10, V20 and Dmean Gy of left lung significantly differed between the two plans (p-value <0.0001, =0.0473 and <0.0001 respectively), but V30 Gy did not (p-value 0.463). V25, D33 and Dmean Gy of heart significantly differed between the two plans (p-value =0.034, <0.0001 and 0.01 respectively), but V10 Gy did not (p-value 0.058). V5 of both right breast and right lung significantly differed between the two plans (p-value <0.0007 and =0.0112, respectively). Also Dmean of both right breast and right lung significantly differed between the two plans (p-value <0.0001 for both). The mean conformity index did not significantly differ, p-value 0.142. There was a significant difference between the mean MUs of the two plans as well, p-value <0.0001.
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Date Issued
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2015
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PURL
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http://purl.flvc.org/fau/fd/FA00005901
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Format
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Document (PDF)
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Title
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Dosimetric Consequences From Minimal Displacements In Abpi With Savi Applicators.
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Creator
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Chandrasekara, Shereen, Pella, Silvia, Leventouri, Theodora, Graduate College
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Abstract/Description
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Purpose: To highlight the importance of provide proper solid immobilization initially and in every treatment in ABPI with brachytherapy. Materials and Methods: 100 patients receiving brachytherapy treatments in ABPI using the Savi applicators were considered for the study. The CT scans used in the initial plan was compared with every scan obtained before each treatment. Each of these scans were exported in the planning system and registered with the initial plan. Dosimetric evaluations were...
Show morePurpose: To highlight the importance of provide proper solid immobilization initially and in every treatment in ABPI with brachytherapy. Materials and Methods: 100 patients receiving brachytherapy treatments in ABPI using the Savi applicators were considered for the study. The CT scans used in the initial plan was compared with every scan obtained before each treatment. Each of these scans were exported in the planning system and registered with the initial plan. Dosimetric evaluations were performed with their consequences to the ribs and the skin surface. Results: Making the dosimetric comparison for the critical points on the ribs and skin due to very small changes in the interfractionation position revealed dramatic differences in the maximum dose to these critical organs. The cavity's volume manifested changes between fractions as well as the distances to the two critical organs. Therefore the maximum dose manifested variance between 10 and 32 in both of the sites Conclusions: This study demonstrates that using CT scan before each treatment will minimize the risk of delivering undesired high doses to the critical organs. This reveals the urgent need of increasing and improving the immobilization methods when treating ABPI with Savi. In 30 of the cases re-planning was necessary between fractions therefore we conclude that in each case the treatment and planning teams must be prepared for re-plan as needed.
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Date Issued
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2015
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PURL
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http://purl.flvc.org/fau/fd/FA00005872
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Format
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Document (PDF)