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Sökning: onr:"swepub:oai:DiVA.org:liu-117854" > Analytical Anisotro...

Analytical Anisotropic Algorithm versus Pencil Beam Convolution for treatment planning of breast cancer: implications for target coverage and radiation burden of normal tissue

Flejmer, Anna M., (författare)
Linköpings universitet, Avdelningen för kliniska vetenskaper, Linköpings universitet, Medicinska fakulteten, Region Östergötland, Onkologiska kliniken US
Dohlmar, Frida, (författare)
Region Östergötland, Radiofysikavdelningen US, Linköpings universitet, Medicinska fakulteten, Linköpings universitet, Avdelningen för radiologiska vetenskaper
Nilsson, Mats, (författare)
Futurum - Academy for Health and Care, Jönköping
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Stenmarker, Margaretha, (författare)
Futurum - Academy for Health and Care, Jönköping
Dasu, Alexandru, (författare)
Östergötlands Läns Landsting, Radiofysikavdelningen US, Linköpings universitet, Medicinska fakulteten, Linköpings universitet, Avdelningen för radiologiska vetenskaper
visa färre...
2015
Engelska.
Ingår i: Anticancer Research. - International Institute of Anticancer Research. - 0250-7005 .- 1791-7530. ; 35:5, s. 2841-2848
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • <p><em>Aim:</em> The present study aimed to investigate the implications of using the analytical anisotropic algorithm (AAA) for calculation of target coverage and radiation burden of normal tissues. Most model parameters, recommendations and planning guidelines associated with a certain outcome are from the era of pencil beam convolution (PBC) calculations on relatively simple assumptions of energy transport in media. Their relevance for AAA calculations that predict more realistic dose distributions needs to be evaluated. <em>Patients and Methods:</em> Forty patients with left-sided breast cancer receiving 3D conformal radiation therapy were planned using PBC with a standard protocol with 50 Gy in 25 fractions according to existing re-commendations. The plans were subsequently recalculated with the AAA and relevant dose parameters were determined and compared to their PBC equivalents. <em>Results:</em> The majority of the AAA-based plans had a significantly worse coverage of the planning target volume and also a higher maximum dose in hotspots near sensitive structures, suggesting that these criteria could be relaxed for AAA-calculated plans. Furthermore, the AAA predicts higher volumes of the ipsilateral lung will receive doses below 25 Gy and smaller volume doses above 25 Gy. These results indicate that lung tolerance criteria might also have to be relaxed for AAA planning in order to maintain the level of normal tissue toxicity. The AAA also predicts lower doses to the heart, thus indicating that this organ might be more sensitive to radiation than thought from PBC-based calculations. <em>Conclusion:</em> The AAA should be preferred over the PBC algorithm for breast cancer radiotherapy as it gives more realistic dose distributions. Guidelines for plan acceptance might have to be re-evaluated to account for differences in dose predictions in order to maintain the current levels of control and complication rates. The results also suggest an increased radiosensitivity of the heart, thus indicating that a revision of the current models for cardiovascular complications may be needed.</p>

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Nyckelord

breast radiotherapy
dose calculation algorithm
analytical anisotropic algorithm
pencil beam convolution
planning guidelines

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