Dosimetric comparison of conventional wedge fields vs IMRT

A dosimetric comparison of conventional wedge fields versus ‘forward-planned’ IMRT for tangential breast radiotherapy.

Authors:

H. Kerr, J. Pettingell, K. Walsh, M. Robb, P. Peters, N. McAndrew, B. Mzenda, A. Eve, S. Razaq, A. Penny.

Purpose: 

The Royal College of Radiologists recently stated[1, 2] there is evidence in breast cancer that forward-planned tangential IMRT can be used to reduce the toxicity seen in conventional wedged breast radiotherapy. They referenced the clinical trial carried out by the Royal Marsden Hospital[3], published in 2007, which found a significant association of late adverse effects with the presence of regions receiving doses ≥ 105% of the prescribed dose.

Following these recommendations we treat all breast patients where the maximum dose in the conventional wedged technique equals or exceeds 105%, with forward-planned IMRT. This study evaluates the reduction in the ‘clinical maximum’ dose (2cc) achieved using forwardplanned IMRT and investigates whether there is any correlation between the patient ‘separation’ and magnitude of the reduction in maximum dose.

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