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This study aimed to evaluate whether the field-in-field FIF technique was more vulnerable to the impact of respiratory motion than irradiation using physical wedges PWs.

Ten patients with early stage breast cancer were enrolled. Computed tomography CT was performed during free breathing FB. During respiratory motion, the dose parameters stay within acceptable range irrespective of irradiation technique used although the amount of change in dose parameters was smaller with FIF technique. Most patients with early stage breast cancer are administered breast-conserving treatment consisting of wide excision and postoperative whole breast radiotherapy. This form of postoperative radiotherapy reduces the risk of local recurrence and results in a long-term survival similar to that obtained with mastectomy.

In recent years, the field-in-field FIF technique has become a Daily motion breast breast performed method of administering tangential whole breast radiotherapy, in addition to the use of physical wedge PWs. Several studies have reported that the use of the FIF technique allows for the better control of dose homogeneity. The purpose of this study was to evaluate whether the FIF technique is more vulnerable to Daily motion breast breast impact of respiratory motion than irradiation using PWs.

This planning study included 10 patients with early stage breast cancer, 6 with right-sided, and 4 with left-sided breast cancer. All patients had undergone breast-conserving surgery and implantation of 4 surgical clips on the tumor bed, 2 of which had been placed in the nipple side of the tumor bed and 2 on each medial and lateral side of the tumor bed.

After radiopaque Free latina big round ass had been Daily motion breast breast at the midline, the mid-axillary line, a site 1 cm below the infra-mammary fold, and at the level of the head of the clavicle, scanning was performed in 2. Images fusion was easy and very precise because the CT scans were obtained continuously without any movement of the body.

The remaining whole breast was contoured as the clinical target volume CTV with reference to the radiopaque markers. The evaluated planning target volume PTVeval was edited 5-mm of the build-up region from the skin surface of the breast.

The delineation was then moved and corrected on each CT slice, if necessary. CLD is defined as the distance between the deep field edge and the interior chest wall at the central axis.

None of the reference Jasmine asian amateur jasmin was located on the lung parenchyma or the border between the lung and chest wall. The prescribed dose was 50 Gy in 25 fractions. The dose calculation algorithm used was according to the pencil-beam convolution method, and the Batho power-law method was used to correct for tissue inhomogeneities.

After beam weighting had been optimized for each case, the medial field was copied as the subfield. All additional subfields were set not to shield the reference point. The maximum, mean, and minimum doses delivered to each surgical clip were also calculated.

Dosimetric parameters were compared using the Wilcoxon signed-rank test. A p value less than 0. Daily motion breast breast length of movement of each surgical clip from EX-CT to IN-CT in 3 directions horizontal, anteroposterior, and craniocaudal and three-dimensional vector displacement were measured. The median age of the patients was 54 Daily motion breast breast range, 47 to 66 years.

As shown in Table 1which lists the displacement lengths of the clips in each direction, the average displacement length was the largest in the anteroposterior direction and the average three-dimensional vector displacement was 7. No statistical differences were found regarding the amount of change for each surgical clip according to dose distribution between the IN-plan and FB-plan, or between the EX-plan and FB-plan.

In some cases, the dorsal part of the PTVeval was out of the irradiation field. In the IN plan, the thoracic wall was moved to the anterior and was included to a greater extent in the irradiation field. Although the PTVeval parameters were better, the irradiated lung volume increased.

No significant differences were found regarding the amount of change in any parameter. Mean dose delivered to the evaluated planning target volume using the field-in-field and Daily motion breast breast wedges Daily motion breast breast during free breathing and light inhalation.

In a study of the effect of respiratory motion on breast tangential radiotherapy, Furuya et al. The FIF technique has been reported to be a useful method of breast tangential radiotherapy. Compared to the use of open-field irradiation with or without a PW, the use of the FIF technique allows for a reduction in Hot sexy naked girls wet vagina size of the high-dose region and the HI.

Despite this concern, a few reports have evaluated the effect of respiratory motion on breast tangential radiotherapy using the FIF technique. Nakamura et Daily motion breast breast. However, as their simulation imitated respiratory motion, the deformation of thorax was not considered. To evaluate the effect of respiratory motion on an FIF plan, Bedi et al. However, no significant differences were found between the plans regarding the amount of change in the HI, which we hypothesized, may have been due Daily motion breast breast the small number of cases examined.

In conclusion, the results of this study indicate that the amount of change in dose parameters due to respiratory motion was smaller with the FIF technique than with irradiation using physical wedges, within an acceptable range. National Center for Biotechnology InformationU. Journal List Radiol Oncol v. Radiol Oncol. Published online Jan Author information Article notes Copyright and License information Disclaimer.

Received Jan 20; Accepted Mar This article has been cited by other articles in PMC. Abstract Background This study aimed to evaluate whether the field-in-field FIF technique was more vulnerable to the impact of respiratory motion than irradiation using physical wedges PWs. Patients and methods Ten patients with early stage breast cancer were enrolled.

Conclusions During respiratory motion, the dose parameters stay within acceptable range irrespective of irradiation technique used although the amount of change in dose parameters was smaller with FIF technique.

Keywords: breast cancer, radiotherapy, field-in-field technique, respiratory motion. Introduction Most patients with early stage breast cancer are administered breast-conserving treatment consisting of wide excision and postoperative whole breast radiotherapy.

Patients and methods This planning study included 10 patients with early stage breast cancer, 6 with right-sided, and 4 with Daily motion breast breast breast cancer. Simulation of radiotherapy planning The remaining whole breast was contoured as the clinical target volume CTV with reference to the radiopaque markers. Open in a separate window.

Results The Daily motion breast breast age of the patients was 54 years range, 47 to 66 years. TABLE 1. Displacement lengths of surgical clips from exhalation CT to inhalation CT. Displacement length mm Standard deviation Minimum mm Maximum mm From lateral to medial 0.

TABLE 2. Discussion In a study of the effect of respiratory motion on breast tangential radiotherapy, Furuya et al. References 1. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and year survival: An review of the randomized trial. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer.

N Engl J Med. One life saved by four prevented recurrences? Update of the Early Breast Cancer Trialists confirms: postoperative radiotherapy improves survival after breast conserving surgery. Strahlenther Onkol. Dosimetric comparison of the field-in-field technique Daily motion breast breast tangential wedged beams for breast irradiation.

Jpn J Radiol. Whole breast irradiation for small-sized breasts after conserving surgery: is the field-in-field technique optimal? Breast Cancer. Sasaoka M, Futami T. Dosimetric evaluation of whole breast radiotherapy using field-in-field technique in early-stage breast cancer.

Int J Clin Oncol. Dosimetric comparion of three different external beam whole breast irradiation techniques. Adv Ther. Dosimetric comparison of field in field intensity-modulated radiotherapy technique with conformal radiotherapy techniques in breast cancer. Performance evaluation of field-in-field technique for tangential Daily motion breast breast irradiation. Jpn J Clin Oncol. Lung and heart dose volume analyses with CT simulator in radiation treatment of breast cancer.

The dosi-metric impact of respiratory breast movement and daily setup error on tangential whole breast irradiation using conventional wedge, field-in-field and irregular surface compensator techniques. J Radiat Res. Quantification of cold spots caused by geometrical uncertainty in field-in-field techniques for whole breast radiotherapy. Comparison of radiotherapy treatment plans for left-sided breast cancer patients based on there- and four-dimensional computed tomography imaging.

Clin Oncol R Coll Radiol ; 23 —7. Impact of breathing motion on whole breast radiotherapy: a dosimetric analysis using active breathing control. Support Center Support Center. External link. Please review our privacy policy.


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