Open AccessForward-planned intensity modulated radiation therapy using a cobalt source: A dosimetric study in breast cancer
Author(s) -
Savino Cilla,
Joseph Kigula-Mugambe,
Cinzia Digesù,
G. Macchia,
Solomon Bogale,
Mariangela Massaccesi,
D. Dawotola,
Francesco Deodato,
Milly Buwenge,
L. Caravatta,
Angelo Piermattei,
Vincenzo Valentini,
Alessio Giuseppe Morganti
Publication year - 2013
Publication title -
journal of medical physics/journal of medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.292
H-Index - 24
eISSN - 1998-3913
pISSN - 0971-6203
DOI - 10.4103/0971-6203.116367
Subject(s) - homogeneity (statistics) , nuclear medicine , medicine , dosimetry , radiation therapy , breast cancer , cobalt 60 , monitor unit , radiation treatment planning , radiology , mathematics , cancer , irradiation , statistics , physics , nuclear physics
This analysis evaluates the feasibility and dosimetric results of a simplified intensity-modulated radiotherapy (IMRT) treatment using a cobalt-therapy unit for post-operative breast cancer. Fourteen patients were included. Three plans per patient were produced by a cobalt-60 source: A standard plan with two wedged tangential beams, a standard tangential plan optimized without the use of wedges and a plan based on the forward-planned "field-in-field" IMRT technique (Co-FinF) where the dose on each of the two tangential beams was split into two different segments and the two segments weight was determined with an iterative process. For comparison purposes, a 6-MV photon standard wedged tangential treatment plan was generated. Dmean, D98%, D2%, V95%, V107%, homogeneity, and conformity indices were chosen as parameters for comparison. Co-FinF technique improved the planning target volume dose homogeneity compared to other cobalt-based techniques and reduced maximum doses (D2%) and high-dose volume (V110%). Moreover, it showed a better lung and heart dose sparing with respect to the standard approach. The higher dose homogeneity may encourage the adoption of accelerated-hypofractionated treatments also with the cobalt sources. This approach can promote the spread of breast conservative treatment in developing countries.