Gönül KEMİKLER, Işık ASLAY, Seden KÜÇÜCÜK, Murat OKUTAN, Aydın ÇAKIR

Memenin elektron huzmesi ile ek doz tedavisinde cerrahi skara ve kliplere dayalı tedavi planlamalarının karşılaştırılması

Meme koruyucu cerrahi sonrası radyoterapide, elektron ek doz (boost) alanının, klinik verilerle cerrahi insizyona göre ve kliplere göre saptandığı iki farklı tedavi planlaması, doz optimizasyonu yönünden karşılaştırıldı. GEREÇ VE YÖNTEM Çalışma, cerrahi girişim sırasında tümör yatağının sınırları kliplerle işaretlenmiş 25 hastada yapıldı. İlk aşamada, bu hastalarda cerrahi klipler gözönüne alınmadı (tip I). Daha sonra cerrahi klipler dikkate alınarak 3D tedavi planlaması yapıldı (tip II). Tip II planlama esas alınarak tip I'e dayalı planlama; enerji, alan boyutu, gantri açısı, kolimatör açısı ve alan merkezi parametreleri karşılaştırıldı.BULGULAR Yapılan karşılaştırma sonucuna göre tip I planlamada; 25 hastanın 12'sinde enerji, 20'sinde alan boyutu, 12'sinde gantri açısı, 6'sında kolimatör açısı ve 18'inde de alan merkezi üzerinde değişiklik gerekti.SONUÇ Bu veriler ışığında lokal başarısızlığı azaltmak ve hedef hacimde optimum doz dağılımı elde etmek için, meme ek doz ışınlamasında bilgisayarlı tomografi kesitleri üzerinden konformal planlama yapılmasını önermekteyiz.

A comparison between surgical scar and clips-guided treatment plans in breast electron boost

OBJECTIVES In general, breast electron boost treatment planning is made using surgical scars or clips placed in the tumor bed. The aim of this study was to compare these two treatments plans in terms of dose optimization. METHODS Twenty-five patients who had surgical clips placed in the tumor bed during tumor excision were evaluated. At first, surgical clips were not taken into account in these patients (type I). In the secondary stage, the treatment plan (type II) was performed considering surgical clips. Taking type II treatment plan as a basis, type I treatment plan was compared in terms of energy, field size, gantry angle, collimator angle and field center parameters.RESULTS When compared with Type I plan, changes were observed in the electron energy used in the treatment of 12 patients, the electron fields of 20 patients, the gantry angles of 12 patients, the collimator angles of 6 patients and the field centers of 18 patients when surgical clips were considered.CONCLUSION This study demonstrates that in breast boost irradiation, conformal planning made using CT slices was preferred to obtain optimum dose distribution at the target volume.

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