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유방암 환자의 Field-in-Field Technique 치료 시 호흡의 움직임에 따른 선량 평가

Evaluation of the Dose According to the Movement of Breath During Field-in-Field Technique Treatment of Breast Cancer Patients

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참고문헌

키워드

주제분류방사선과학

초록

Field-in-Field Technique is applied to the radiation therapy of breast cancer patients, and it is possible to compensate the difference in breast thickness and deliver uniform dose in the breast. However, there are several fields in the treatment field that result in a more complex dose delivery than a single field dose delivery. If the patient's respiration is irregular during the delivery of the dose by several fields and the change of respiration occurs, the dose distribution in the breast changes. Therefore, based on the computed tomography images of breast cancer patients, a human model was created by using a 3D printer (Builder Extreme 1000) to describe the volume in the same manner. A computerized tomography (CT) of the human body model was performed and a treatment plan of 260 cGy / fx was established using a 6-MV field-in-field technique using a computerized treatment planning system (Eclipse 13.6, Varian, USA). The distribution of the dose in the breast according to the change of the respiration was measured using a moving phantom at 0.1 cm, 0.3 cm, 0.5 cm amplitude, using a MOSOXIDE Silicon Field Effect Transistor (MOSFET, Best Medical, Canada) Were measured and compared. The distribution of dose in the breast according to the change of respiration showed similar value within ± 2% in the movement up to 0.3 cm compared to the treatment plan. In this experiment, we found that the dose distribution in the breast due to the change of respiration when the change of respiration was increased was not much different from the treatment plan.

Abstract

Field-in-Field Technique is applied to the radiation therapy of breast cancer patients, and it is possible to compensate the difference in breast thickness and deliver uniform dose in the breast. However, there are several fields in the treatment field that result in a more complex dose delivery than a single field dose delivery. If the patient's respiration is irregular during the delivery of the dose by several fields and the change of respiration occurs, the dose distribution in the breast changes. Therefore, based on the computed tomography images of breast cancer patients, a human model was created by using a 3D printer (Builder Extreme 1000) to describe the volume in the same manner. A computerized tomography (CT) of the human body model was performed and a treatment plan of 260 cGy / fx was established using a 6-MV field-in-field technique using a computerized treatment planning system (Eclipse 13.6, Varian, USA). The distribution of the dose in the breast according to the change of the respiration was measured using a moving phantom at 0.1 cm, 0.3 cm, 0.5 cm amplitude, using a MOSOXIDE Silicon Field Effect Transistor (MOSFET, Best Medical, Canada) Were measured and compared. The distribution of dose in the breast according to the change of respiration showed similar value within ± 2% in the movement up to 0.3 cm compared to the treatment plan. In this experiment, we found that the dose distribution in the breast due to the change of respiration when the change of respiration was increased was not much different from the treatment plan.

참고문헌 (16)

  1. Central Cancer Registry Center in Korea, "Cancer Facts & Figures 2017" (2017), Ministraty of Health and Welfare
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  7. JinHeeKim, "Breast Conserving Operation and Radiation Therapy in Early Breast Cancer:Interim Analysis", Radiation oncology journal, 19(1), pp.27~33 (2001), 대한방사선종양학회
  8. Fisher B, "Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer", N Engl J Med, 333, pp.1456~1461 (1995)
  9. Fowble BL, "Ten year results of nservative surgery and irradiation for stage I and II breast cancer", Int J Radiat Oncol Biol Phys, 21, pp.269~277 (1991)
  10. 지의규, "유방암에서 유방보존수술 및 수술 후 방사선치료의 결과", Radiation oncology journal, 26(3), pp.142~148 (2008), 대한방사선종양학회
  11. Tanaka H, "Determination of the optimal method for the field-in-field technique in breast tangential radiotherapy", Radiat Res, 55(4), pp.769~773 (2014)[DOI]
  12. Tsuchiya K, "Dosimetric comparison between intensity-modulated radiotherapy and standard wedged tangential technique for whole-breast radiotherapy in Asian women with relatively small breast volumes", Radiol Phys Technol, 7(1), pp.67~72 (2014)[DOI]
  13. Pili G, "Geometric and dosimetric approach to determine probability of late cardiac mortality in left tangential breast irradiation: comparison between wedged beams and field-in-field technique", Int J Radiat Oncol Biol Phys, 81(3), pp.894~900 (2011)[DOI]
  14. Tanaka H, "Impact of respiratory motion on breast tangential radiotherapy using the field-in-field technique compared to irradiation using physical wedges", Radiol Oncol, 48(1), pp.94~98 (2014)[DOI]
  15. Onal C, "Dosimetric comparison of the field-in-field technique and tangential wedged beams for breast irradiation", Jpn J Radiol, 30(3), pp.218~226 (2012)[DOI]
  16. Darby SC, "Long-term mortality form heart disease and lung cancer after radiotherapy for early breast cancer : prospective cohort study of about 300000 women in US SEER cancer registries", Lancet Oncol, 6, pp.557~565 (2005)

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