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A new strategy for radiation therapy dosimetry planning (RTDP) used to reducedose estimation errors due to respiratory motion in breast treatment wasillustrated and evaluated in this study. On CT data set acquired for breasttreatment, six different RTDP tangential techniques were performed: (i)three-dimensional conformal radiotherapy (3DCRT) with physical wedge, (ii)3DCRT with virtual wedge, (iii) motion management technique (MMT) with physicalwedge, (iv) MMT with virtual wedge, (v) 3DCRT with field-in-field, and (vi)intensity-modulated radiation therapy (IMRT) with direct aperture optimization.These anti-motion techniques were considered to generate continuous dosedegradation to avoid drastic changes in the delivered doses that involve theedge regions of the beams. A comparison was made between the delivered andsimulated doses, with and without the presence of motions simulations. Thisstudy demonstrates that techniques without motion management can be affected bymotions that can lead to a difference equal to 19 % between the delivered andthe planned doses in a point located near to the beams collimators edges, andto a difference up to 3 % on multi-leaf collimators (MLCs) edges (gamma passrates were 87.9 % for 3%/3mm). These differences were reduced to 11 % and toless than 3 % (gamma pass rates were 100 % for 3%/3mm) when MMT were used. As aconclusion, in tangential techniques motion can affect dose estimations on theMLCs and beams collimators edges. The proposed MMT reduce this effect toestimate the delivered dose accurately.

New dosimetry planning strategy based on continuous dose gradient used  to reduce dose estimation errors due to respiratory motion in breast  radiation therapy