Clinical implementation of combined modulated electron and photon beams with conventional MLC for accelerated partial breast irradiation

Purpose: To report the clinical implementation of a novel external beam radiotherapy technique for accelerated partial breast irradiation treatments based on combined electron and photon modulated beams radiotherapy (MERT+IMRT) with conventional MLC. Materials and methods: A group of patients was se...

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Detalles Bibliográficos
Autores: Míguez, Carlos, Jiménez Ortega, Elisa Eugenia, Palma, Bianey A., Miras, Héctor, Ureba Sánchez, Ana María, Arráns, Rafael, Carrasco Peña, Francisco de Asís, Illescas Vacas, Ana, Leal Plaza, Antonio
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2017
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/154914
Acceso en línea:https://hdl.handle.net/11441/154914
https://doi.org/10.1016/j.radonc.2017.06.011
Access Level:acceso abierto
Palabra clave:Accelerated partial breast irradiation (APBI)
Modulated electron radiotherapy
Breast cancer
Descripción
Sumario:Purpose: To report the clinical implementation of a novel external beam radiotherapy technique for accelerated partial breast irradiation treatments based on combined electron and photon modulated beams radiotherapy (MERT+IMRT) with conventional MLC. Materials and methods: A group of patients was selected to test the viability of the technique. The prescribed dose was 38.5 Gy, following a hypofractionated schema, and the structures were defined following the NSABP-B39/RTOG-0413 protocol. The plans were calculated with an in-house Monte Carlo based planning system to consider explicitly the particle interactions with the MLC. An ad-hoc breast phantom was designed for a specific QA protocol. A reduced SSD was used for electron beams. Toxicity and cosmetic effects were assessed at every follow-up visit. Results: All the plans achieved the dosimetric objectives and fulfilled the specific quality assurance protocol. Treatment delivery did not entail additional drawbacks for the clinical routine. Moderate or severe grade of toxicity was not reported, and the cosmetic results were comparable to those obtained with other APBI techniques. Conclusions: Results showed that MERT+IMRT with the MLC is a feasible and secure technique, and easy to be extended to other centers with the implementation of the adequate software for planning.