By Jennifer R. Bellon, Julia S. Wong, Shannon M. MacDonald, Alice Y. Ho
This booklet addresses the day by day remedy making plans concerns that radiation oncologists tend to come upon through the therapy of breast melanoma sufferers and offers quite a few functional “tips” that might help in navigation of the remedy making plans approach, from delineation of the tumor limitations to discrimination of adjoining general tissues and significant buildings susceptible to radiation damage. alterations in aim delineation and therapy making plans based on strategy are emphasised, with insurance of traditional radiation remedy and complicated ideas together with cardiac-sparing ways, e.g., utilizing lively respiring keep an eye on, intensity-modulated radiation treatment, proton beam remedy, and electron beam remedy submit mastectomy. person chapters additionally specialize in radiation setup and verification innovations and radiation therapy making plans platforms. The booklet, that is a part of the Springer sequence Practical courses in Radiation Oncology, is designed for hands-on use by means of radiation oncology residents/fellows in education and practising radiation oncologists.
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Extra info for Radiation Therapy Techniques and Treatment Planning for Breast Cancer
Example text
However, because the match line between the supraclavicular field and the photon tangents is generally set at the caudal border of the clavicle, the first contoured IM nodes sit below this match and are included in the breast or chest wall tangent photon fields. Thus, a traditional mono-isocentric technique may be used. In the case of partially wide tangents, the posterior field border is placed deeply enough that the contoured internal mammary nodes are covered in the fields. This results in fields that would include an uncomfortably high volume of the heart and lung in the fields if not further modified.
This CT artifact can affect the dose calculations. This problem can usually be solved by contouring the IMP and assigning a Hounsfield unit (HU) corresponding to the type of material used for the port. Also, the areas of photon starvation and metal streaking are contoured and assigned HU of the soft tissue. Another way of eliminating the artifacts in the CT scan is to use artifact reduction software, which recently became commercially available by most CT vendors. , Acuros (Varian Medical Systems) or collapsed cone convolution superposition (Philips) (Fig.
Other plastic surgeons prefer completing the implant exchange prior to initiating radiotherapy as the wound healing may be better in unirradiated tissues [25, 26]. Treatment of the reconstructed breast with a temporary TE in place or with the permanent implant can create potential difficulty with the beam arrangements, dose distribution, and use of a bolus. Because of the uneven contour, the bolus may not conform perfectly to the chest wall. It may be useful to use in-vivo dosimeters (thermoluminescent dosimeter (TLD) or optically stimulated luminescent dosimeter (OSLD)) to ensure adequate dose to the skin.