Abstract
The combination of radiotherapy treatments and breast reconstruction, using temporary tissue expanders, generates several concerns due to the presence of a magnetic valve inside the radiation field. The objective of this work is to evaluate a radiotherapy treatment planning for a patient using a tissue expander. Isodose curve maps, obtained using radiochromic films, were compared to the ones calculated with two different dose calculation algorithms of the Eclipse radiotherapy Treatment Planning System (TPS), considering the presence or absence of the heterogeneity. The TPS calculation considering the presence of the heterogeneity shows changes around 5% in the isodose curves when they were compared with the calculation without heterogeneity correction. This calculation did not take in account the real density value of the heterogeneity. This limitation was quantified to be around 10% in comparison with the TPS calculation and experimental measurements using the radiochromic film. These results show that the magnetic valve should be taken in account in dose calculations of the TPS. With respect to the AAA and Pencil Beam Convolution algorithms, when the calculation is compared with the real distribution, AAA presents a distribution more similar to experimental dose distribution.
Highlights
The technique of breast reconstruction, that makes use of a temporary tissue expander, has been increased in the preference of mastectomized women
As the readings were equivalent, it was considered that the phantom is validated to be used for dose calculation in experimental measurements
As the results found with Monte Carlo simulations showed differences in attenuation calculations around 8–9% when the two densities were compared, the difference found between Treatment Planning System (TPS) and radiochromic film measurements was believed to be caused by the limitation of the TPS in assigning the nominal density value of the magnetic device
Summary
The technique of breast reconstruction, that makes use of a temporary tissue expander, has been increased in the preference of mastectomized women. Among the benefits of this procedure, the short duration of the surgery, the mammary volume manipulation, preservation of sensibility and colour skin can be highlighted [1]. This technique is divided in two stages. The tissue expander (a silicon bag) is implanted totally empty above the breast muscle of the patient. Following, it is periodically inflated with a saline solution until it reaches the desired.
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