Out of Field Breast Doses as an Undesired Consequence of Cervical Cancer Radiotherapy

Out of Field Breast Doses as an Undesired Consequence of Cervical Cancer Radiotherapy

OBJECTIVEUnwanted doses may occur in distant organs, outside of the region where we want to be irradiated in patients treated with radiotherapy. These doses cannot be accounted accurately by the treatment planningsystem (TPS) yet. In our study, the doses received by the breast tissue outside the field of irradiation areaimed to investigate dosimetrically in irradiation with three-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiation therapy (IMRT) and volumetric arc therapy (VMAT) techniquesfor cervical cancer.METHODSThe patient was simulated in Alderson Rando phantom and irradiated with three different techniquesin Varian DHX (Rapidarc) linear accelerator with 48 Gy in 24 fractions. Doses that occur in the breasttissue were measured using thermoluminescent dosimeters and compared with each other and the dataobtained from TPS.RESULTSThe dose values in the right and left breasts were found to be statistically similar to each other (p>0.05),whereas significant differences were detected between different techniques. The mean calculated breastdoses were 7.16±1.61 cGy in 3D-CRT, 27,75±3,88 cGy in IMRT and 12,20±2,65 cGy in VMAT, respectively.CONCLUSIONThe breast tissue doses are significantly lower in 3D-CRT and VMAT compared with IMRT. This findingshould be considered while choosing a treatment technique, especially in young patients with cervicalcancer.

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  • 1. WHO. Cancer fact sheets: Cervical cancer: Estimated incidence, mortality and prevalence (5 years) worldwide in 2012. International Agency for Research on Cancer and World Health Organization; 2012. Available at: http://gco.iarc.fr/today/data/pdf/fact-sheets/ cancers/cancer-fact-sheets-16.pdf
  • 2. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin 2005:55(2):74−108.
  • 3. Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 2006;24(14):2137−50.
  • 4. Khan FM. The Physics of Radiation Therapy, 3rd edition. Philadelphia; Lippincott Williams & Wilkins, 2003.
  • 5. Taylor ML, KronT. Consideration of the radiation dose delivered away from the treatment field to patients in radiotherapy. J Med Phys 2011;36(2):59−71.
  • 6. Cho S, Kim SH, Kim CH, Park JG, Park JG, et al. Secondary Cancer Risks in Out-of-field Organs for 3-D Conformal Radiation Therapy. Progress in NUCLEAR SCIENCE and TECHNOLOGY 2011;1:521−4.
  • 7. Stovall M, Blackwell CR, Cundiff J, Novack DH, Palta JR, Wagner LK, et al. Fetal dose from radiotherapy with photon beams: report of AAPM Radiation Therapy Committee Task Group No. 36. Med Phys 1995;22(1):63−82.
  • 8. Jia MX, Zhang X, Yin C, Feng G, Li N, Gao S, et al. Peripheral dose measurements in cervical cancer radiotherapy: a comparison of volumetric modulated arc therapy and step-and-shoot IMRT techniques. Radiat Oncol 2014;9:61.
  • 9. Mansur DB, Klein EE, Maserang BP. Measured peripheral dose in pediatric radiation therapy: a comparison of intensity-modulated and conformal techniques. Radiother Oncol 2007;82(2):179−84.
  • 10.Ceylan C, Güden M, Baş Ayata H, Küçük N, Kiliç A, Engin K. Comparison of different planning techniques and out-of-field doses in bilateral lung irradiation for Wilms’ tumor metastatic to the lung. Turkish J Oncology 2012;27(4):202−11.
  • 11.Martín Rincón C, Jerez Sainz I, Modolell Farré I, España López ML, López Franco P, Muñiz JL, et al. Evaluation of the peripheral dose to uterus in breast carcinoma radiotherapy. Radiat Prot Dosimetry 2002;101(1-4):469−71.
  • 12.Lee B, Lee S, Sung J, Yoon M. Radiotherapy-induced secondary cancer risk for breast cancer: 3D conformal therapy versus IMRT versus VMAT. J Radiol Prot 2014;34(2):325−31.
  • 13.Kase KR, Svensson GK, Wolbarst AB, Marks MA. Measurements of dose from secondary radiation outside a treatment field. Int J Radiat Oncol Biol Phys 1983;9(8):1177−83.
  • 14.Banaee N, Nedaie DR, Esmati E, Nosrati H, Jamali M. Dose measurement outside of radiotherapy treatment field (Peripheral dose) using thermoluminescent dosimeters. Int J Radiat Res 2014;12(4):355−9.
  • 15.Yousif Abdallah YM, Gar-elnabi ME, Bakary AHA, Eltoum AMH, Ali AKM. Calculation of organs radiation dose in cervical carcinoma external irradiation beam using day’s methods. GARJMMS 2014;3(5):090−4.
  • 16.Kinhikar R, Gamre P, Tambe C, Kadam S, Biju G, Suryaprakash, et al. Peripheral dose measurements with diode and thermoluminescence dosimeters for intensity modulated radiotherapy delivered with conventional and un-conventional linear accelerator. J Med Phys 2013;38(1):4-8.
  • 17.D’Agostino E, Bogaerts R, Defraene G, de Freitas Nascimento L, Van den Heuvel F, Verellen D, et al. Peripheral doses in radiotherapy: A comparison between IMRT, VMAT and Tomotherapy. Radiation Measurements 2013;57:62−7.
  • 18.World Health Organization. Comprehensive cervical cancer control: a guide to essential practice. 2nd edition. WHO; Geneva, 2006.
Türk Onkoloji Dergisi-Cover
  • ISSN: 1300-7467
  • Başlangıç: 2015
  • Yayıncı: Ali Cangül
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