22 State of the art and breast cancer treatments in Tomotherapy. (December 2018)

• Record Type: Journal Article
• Authors: Nirrengarten, M.; Nomikossof, N.; Garnier, E.; Cowen, D.
• Is Part Of: Physica medica. Volume 56(2018)Supplement 1
• Page Start: 50
• Publication Date: 2018-12
• Subjects: Medical physics -- Periodicals; Biophysics -- Periodicals; Biophysics -- Periodicals; Imagerie médicale -- Périodiques; Radiothérapie -- Périodiques; Rayons X -- Sécurité -- Mesures -- Périodiques; Physique -- Périodiques; Médecine -- Périodiques; 610.153
• DOI: 10.1016/j.ejmp.2018.09.104
• Languages: English
• ISSNs: 1120-1797

Abstract

Abstract : Introduction: The most common female cancer is breast cancer. Classically performed in 3D conformational technique (RC3D) on a linear accelerator, it can also be performed on other machines such as Tomotherapy, mainly in case of treatment of both breasts or funnel breast. To use this treatment method for more indications of breast cancer requires a comparative study of ballistics from a linear accelerator with those of Tomotherapy. Methods: The treatment delivery on Tomotherapy can be performed helically ("TomoHelical") or using fixed beams ("TomoDirect 3DCRT" and "TomoDirect IMRT"). A state of the art of the methods used supported by a comparative dosimetric study will enable us to associate a privileged treatment technique for each indication. Results: At the time of writing this summary, the first results follow the publications: for breasts with or without tumor bed, TD-IMRT enable to cover the PTV with a better conformation and save better the organs at risk compared to the conventional technique. Nevertheless, it causes a higher inhomogeneity (hot spots) in the target volume. For complete breasts (with nodes and internal breast chain), double breasts and chest walls, the helical technique reduces the pulmonary and/ or cardiac dose. Conclusions: The ballistics performed in Tomotherapy have proven to be mostly equivalent or better than those made in 3D. TD-IMRT appears to be a great technique for the treatment of a breast cancer with or without a tumor bed. The helical technique is adapted for the treatment of complete breasts and chest walls.