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Published in: Strahlentherapie und Onkologie 5/2016

01-05-2016 | Original Article

Treatment of breast cancer with simultaneous integrated boost in hybrid plan technique

Influence of flattening filter-free beams

Authors: Dipl.-Ing. Marzieh Bahrainy, M.Sc., Dr. rer. medic. Matthias Kretschmer, Vincent Jöst, B.Sc., Dipl.-Ing. Astrid Kasch, Prof. Dr. med. Florian Würschmidt, Dr. med. Jörg Dahle, PD Dr. med. Jörn Lorenzen

Published in: Strahlentherapie und Onkologie | Issue 5/2016

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Abstract

Objective

The present study compares in silico treatment plans using hybrid plan technique during hypofractionated radiation of mammary carcinoma with simultaneous integrated boost (SIB). The influence of 6 MV photon radiation in flattening filter free (FFF) mode against the clinical standard flattening filter (FF) mode is to be examined.

Patients and methods

RT planning took place with FF and FFF radiation plans for 10 left-sided breast cancer patients. Hybrid plans were realised with two tangential IMRT fields and one VMAT field. The dose prescription was in line with the guidelines in the ARO-2010-01 study. The dosimetric verification took place with a manufacturer-independent measurement system.

Results

Required dose prescriptions for the planning target volumes (PTV) were achieved for both groups. The average dose values of the ipsi- and contralateral lung and the heart did not differ significantly. The overall average incidental dose to the left anterior descending artery (LAD) of 8.24 ± 3.9 Gy in the FFF group and 9.05 ± 3.7 Gy in the FF group (p < 0.05) were found. The dosimetric verifications corresponded to the clinical requirements. FFF-based RT plans reduced the average treatment time by 17 s/fraction.

Conclusion

In comparison to the FF-based hybrid plan technique the FFF mode allows further reduction of the average LAD dose for comparable target volume coverage without adverse low-dose exposure of contralateral structures. The combination of hybrid plan technique and 6 MV photon radiation in the FFF mode is suitable for use with hypofractionated dose schemes. The increased dose rate allows a substantial reduction of treatment time and thus beneficial application of the deep inspiration breath hold technique.
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Metadata
Title
Treatment of breast cancer with simultaneous integrated boost in hybrid plan technique
Influence of flattening filter-free beams
Authors
Dipl.-Ing. Marzieh Bahrainy, M.Sc.
Dr. rer. medic. Matthias Kretschmer
Vincent Jöst, B.Sc.
Dipl.-Ing. Astrid Kasch
Prof. Dr. med. Florian Würschmidt
Dr. med. Jörg Dahle
PD Dr. med. Jörn Lorenzen
Publication date
01-05-2016
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 5/2016
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-016-0960-5

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