Field matching in breast irradiation

Abstract

INTRODUCTION: In this paper the authors have combined different irradiation techniques for breast and adjacent supraclavicular lymph nodes. The aim was to reduce inhomogeneity in the match-line. METHODS: The CadPlan 6.1.5 three-dimensional treatment planning system was applied in this study for CT based plan using a standard medial and lateral wedged tangential breast portals with the adjacent supraclavicular field. Isocenter is placed at depth on the match-line, where asymmetric jaws are used to produce non-divergent field edges. The tangential fields are shaped using multi-leaf collimator (MLC), by following the curvature of the thorax. In this way the cranial vertical match plane is maintaned without using the breast board. The prescribed dose was 50 Gy at the isocentre. RESULTS: The calculated dose distributions were evaluated in three dimension in the match region of supraclavicular field and the two opposing tangential fields. This method produces a more uniform dose distribution in the target volume and in the match-line. Set-up is fast, this is done without the need for table rotation, or vertical cephalad blocks. The average dose to the ipsilateral lung is reduced using the IMRT (intensity modulated radiotherapy) technique by approximately 10% compared with the conventional technique. Furthermore, this new technique has the possibility to improve the field match between the tangential fields and the parasternal field, while maintaning the field match between the tangential fields and the axillary and supraclavicular fields.