A two‐point scheme for optimal breast IMRT treatment planning

We propose an approach to determining optimal beam weights in breast/chest wall IMRT treatment plans. The goal is to decrease breathing effect and to maximize skin dose if the skin is included in the target or, otherwise, to minimize the skin dose. Two points in the target are utilized to calculate...

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Bibliographic Details
Published inJournal of applied clinical medical physics Vol. 14; no. 6; pp. 307 - 321
Main Author Yao, Weiguang
Format Journal Article
LanguageEnglish
Published United States John Wiley & Sons, Inc 01.11.2013
John Wiley and Sons Inc
Subjects
Algorithms
Breast cancer
breast IMRT
Breast Neoplasms - diagnostic imaging
Breast Neoplasms - radiotherapy
Energy
Female
Humans
Imaging, Three-Dimensional
optimal beam weight
optimal treatment planning
Optimization
Planning
Radiation Oncology Physics
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Intensity-Modulated
Respiration
Skin
Skin - radiation effects
Tomography, X-Ray Computed
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Summary:We propose an approach to determining optimal beam weights in breast/chest wall IMRT treatment plans. The goal is to decrease breathing effect and to maximize skin dose if the skin is included in the target or, otherwise, to minimize the skin dose. Two points in the target are utilized to calculate the optimal weights. The optimal plan (i.e., the plan with optimal beam weights) consists of high energy unblocked beams, low energy unblocked beams, and IMRT beams. Six breast and five chest wall cases were retrospectively planned with this scheme in Eclipse, including one breast case where CTV was contoured by the physician. Compared with 3D CRT plans composed of unblocked and field‐in‐field beams, the optimal plans demonstrated comparable or better dose uniformity, homogeneity, and conformity to the target, especially at beam junction when supraclavicular nodes are involved. Compared with nonoptimal plans (i.e., plans with nonoptimized weights), the optimal plans had better dose distributions at shallow depths close to the skin, especially in cases where breathing effect was taken into account. This was verified with experiments using a MapCHECK device attached to a motion simulation table (to mimic motion caused by breathing). PACS number: 87.55 de
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ISSN:1526-9914
1526-9914
DOI:10.1120/jacmp.v14i6.4525