1
137 SOLID-STATEDETECTOR DOSIMETRY FOR MALE GONADS RADIOPROTECTION IN RADIOTHERAPY M. Bignardi', G Catalano', F. Corrado-, P Feroldi 2, F. Luraschi-, M. Prina', S. Tonoli' 'Radioth , 2Med. Phys. Dep., Spedali Civilidi BRESCIA - ITALY Basic clinical interest and, in some cases, regulatory recommendations request measurement or, at least, estimation of the dose to the male gonads in radiotherapic treaments. Subdiaphragmatic, rectal and post-surgical seminomatarget treatments in adults have been taken into account. The proximity of target volume or the particular request for fertility evaluationmake the problem more relevant. Solid-state detectors give interesting opportunities for in vivo dosimetryout of the therapeutic beams. In vivo and in phantom dosimetry have been performed, in order to set direct data and indirect estimates Ionization chamber measurements have been collected and used as reference values for semiconductors calibration Also thermoluminescent dosimetry has been used for a comparison. Feasibility, accuracy and reproducibility results show that the use of solid state dosimetry for radioprotection in radiotherapy is very stimulating A procedure for the evaluation of male gonads dose in radiotherapy is proposed Solid-state and thermoluminescent dosimetry in some clinical cases have been compared with our protocol evaluations, showingencouragingresults 139 r.t, KJcperIIIIllI oIla1ui ,iiitba J\IIIoIIIn DJ-k bdIothenp, DYN.QAD JmaaiDI <Jroap: Jl M. MooDeyl, P, VIDdcD HeawIl 3 , Z. IqoIl1III, J. VID Dtjt', T. KdI. O.slplll', A. 'nlIIddII', C de Wap'. O. PuIyiocUIa', B. M1hllqlonlau'. B. PraImoI' lMelcl1 P!l)'IIcI DIpc., t.1UYInIly laldaa. LcmdcD. llK. 2 AZ-VUB. DliplRadIodInpy, BnIIIeIs. B!LOItlM. 'INBrr. PIInt, GRIlIa!. 4Al:1de11i1c1l MdIc:II Celeum, RIlIIalI-.:.pe. A-.IIm Le.. NImIBRLANDS. 'HIIIIaId UlIYcI*y oI'I'el:11alio1Y. HIIIiI*I, FINLAND. -. tl8lllpllll Jl!lyIIcI. KIroIbIID IIaIpiIII. S1ldIIaIm, SWBDBN, 'Dc:pc. 01 Ii: NIIl:Ir:Ir Mdc:me. UIM*y 8llIpIlal CJla, GIll, BI!LCJIUM. Dlipl,UWlnkyolPlall,PIInt, CllUlIlCB. DYNARAD Is aJ!urclIaD C'.alIcer1ed AaIaa. wI1IIlIlI CIIn'lIIt 1IIll Illd die I!lIropoID t1DIoa. DYNARADCIIIIaII)' l1li26 pIIdclpIItIIa 1'IIpI'ClIOIIiI13 CIllIIlIriIIl'ClIllllarop& 1'IIIl1llllliDl Groap Is a 1Ub-pJup 01DYNAllAD ClClIlllnId wIIIIlD lIII*lI ollllllmlllal c:IIIIIl illvCllved ill DyIIIIIlIc 1lIdkldaenpy. 1'IIIl Groap _1dliadIId __ IpICIac to imaIIAI IIId dIiI aIlIlnclllmlllO *- dII prollIa oIp1Ol11Jc1Da y1."U"'1oa oIda'Ipy raIIMd IltormIdoa 011110 a.. 1JDIIe. 1'IIIl-uy 01ClIIlIbiIIIIII idlnaIlIClII, IIIllaIparatlq pllIIIIIIric, t'uIIcdClIIallild IIplIIIal dlra,iulo ClIIIimIp b' pIIIIIllaa II 1'IIIl1llOdllldcl far oIlraiDIIIi 1bII_1I'll U beiDa CclmpIl8cI 'I'aaqnipIIy(CT) orl1tenlaIIvdy DIpal (DTS), PoOClII·JlIDc:lrClII 'I'aaIoIfIplIy (PET) or S_PIxxClII JlmIIIIoa CcIIIIpuIId 1'clIIIDppIIy (SPIlC'I)IIld Mtpetic ReIaaaace IIIIIIIDI (MIU). Oae oldie IYIIIIIIlIimI oltlalmlliDlll'OUP Is 110 full tbo iDfcnIIaIiClIIl'ClIll tMlillC1llllCJ* II c:r.- aliDllo data .. 1IIOIt __ II d)'llllllle radIadBapy 1I'IaIIIIL 'l1III1pIlI'ClICII1bouId Joad tollll cnadClII oIllla11l11t1P1* viIlWIudClII oIl1n1Cl111'1, CllDIllanIlld pIIyIIaIotk:al 1lIrldIo:a wbldl CXlIIId euI17 beraIIMd 10 I!IlIaIaIar "-' l'IdIolblnpy 1111 fIlI1bwIDI ..... 1IlI eady IillpWDce oItbe I!IIIIIDI <JnlIIp i1111l1 palWIIIIlI oIlIIII ailII. 138 THE TARGETED STEREOTACTIC RADIOSURGERY: AN OPTIMIZED TREATMENT TECHNIQUE FOR PATIENTS WITH INTRACRANIA. VASCULAR MALFORMATIONS. Prof. Dr. R. DATTA and Prof. Dr. S. DATTA Department of Radiology, LSU School of Medicine, P.O. Box 33932, Shreveport, Louisiana-71130-3932, USA. Stereotactic radiosurgery (SRS), a relatively new special treat- ment technique, has already occupied a prominent place in the expanding armamentarium of therapeutic interventions of vas- cular abnormality associated with intracranial malformations. Usually, a massivedose of ionizing radiation, with single fraction is given by this procedure. Unlike multifractionated therapy. a very large single dose of radiation reduces the therapeutic ratio (i.e. radiobiologicallycontraindicated).Various different phys- ical methods and treatment devices have been developed to deliv- er highly localized dose distributions requiring targeting accuracy on the order of a millimeter. The physical accuracy of treatment outcome is comparable between methods. The physical aspects of treatment techniques of various methods and their impact on the treatment and radiobiological considerations will be discussed. The technique appears to be applicable to patients with intracrani- al neoplasms in whom tumor volume is small and surgically inac- cessible, and in whom limited or no prior chemotheraphy has been administered. What is stereotactic radiosurgery, how it works, how it differs from stereotactic radiotherapy (SRT), who are the potential candidates for treatment, and few other exciting questions will be addressed to help physicians and physicists the appropriate use of this new emerging sophisticated technology. 140 VERSUS THREE·DIMENSIONAL TREATMENT PLANNING OF TANGENTIAL BREAST IRRADIATION. E.M.F. DAMEN, I.A.D. BRUINVlS, B.J. MIJNHEER The Netherlands Cancer Institute / Antoni van Leeuwenhoek Huis, Amsterdam, The Netherlands Purpose: Full three-dimensional (3-D) treatment planning requires 3-D patientcontours and density inlormabon, derived from CTscanning or from other 3-Dcontouring methods. These contouring techniques are time consuming, and are olten not available or cannot be used. Two- dimensional (2-D) treatment planning can be performed usingonlya few patientcontours, made with much simplertechniques,in combination with simulator images for estimating the lung position. In order to investigate the need lor lull 3-Dplanning, we compared the performance 01both a 2- D and a 3-D planning system in calculating absolute dose values and relative dose distributions in tangential breast irradiation. Methods: Two breast-shaped phantoms were used in this stUdy. The first phantom consists 01 a polyethylene mould, filled with water and cork to mimic the lung. An ionization chamber can be inserted in the phantom et fixed positions, The second phantom is made 01 25 transverse slices 01 polystyrene and cork, made with a computerized milling machine from CT inlormation. Inthis phantom, films can be Inserted inthree sagittal planes. Both phantoms have been irradiated with two tangential 8 MV photon beams. The measured dose distribution has been compared with the dose distribution predicted by the two planning systems. Results: In the central plane, the 3-D planning system predicts the absolute dose with an accuracy 01 0.5 - 4%. The dose at the isocentre 01 the beams agrees within 0.5%with the measured dose. The 2-D system predictsthe dose with an accuracy 010.9 - 3%.Thedose calculated at the isocentre is 2.6%higherthan the measured dose, because missing lateral scatter is not taken intoaccount inthis planning system. Inoil-axis planes. the calculated absolutedose agrees with the measured dose within 4%lor the 2-D system and within 6% lor the 3-Dsystem. However, the relative dose distribution is predicted better by the 3·D planning system. Conclusions: This study shows that an algorithm lor the correction 01 missing lateral scatter is an essential part 01 the treatment planning 01 tangential fields, Furthermore, is shownthat a multi-plane 2-D calculation might be su1licienUy accurate in most cases. 837

Two-dimensional versus three-dimensional treatment planning of tangential breast irradiation

  • Upload
    iad

  • View
    214

  • Download
    2

Embed Size (px)

Citation preview

Page 1: Two-dimensional versus three-dimensional treatment planning of tangential breast irradiation

137

SOLID-STATEDETECTOR DOSIMETRYFOR MALEGONADS RADIOPROTECTION IN RADIOTHERAPY

M. Bignardi', G Catalano', F. Corrado-, P Feroldi2,F. Luraschi-,M. Prina', S. Tonoli''Radioth , 2Med. Phys. Dep., SpedaliCivilidi BRESCIA - ITALY

Basic clinical interest and, in some cases, regulatoryrecommendations request measurement or, at least,estimation of the dose to the male gonads in radiotherapictreaments.Subdiaphragmatic, rectal and post-surgical seminomatargettreatments in adults have been taken into account. Theproximity of target volume or the particular request forfertility evaluationmake the problem more relevant.Solid-state detectors give interesting opportunities for invivo dosimetryout of the therapeutic beams.In vivo and in phantom dosimetry have been performed, inorder to set direct data and indirect estimates Ionizationchamber measurements have been collected and used asreference values for semiconductors calibration Alsothermoluminescent dosimetry has been used for acomparison.Feasibility, accuracy and reproducibility results show thatthe use of solid state dosimetry for radioprotection inradiotherapy is very stimulating A procedure for theevaluationof male gonads dose in radiotherapy is proposedSolid-state and thermoluminescent dosimetry in someclinical cases have been compared with our protocolevaluations, showingencouragingresults

139

r.t, KJcperIIIIllI oIla1ui,iiitba J\IIIoIIIn DJ-k bdIothenp,

DYN.QAD JmaaiDI <Jroap: Jl~,M. MooDeyl, P,VIDdcDHeawIl3,Z.IqoIl1III, J. VID Dtjt', T.KdI. O.slplll',A. 'nlIIddII', Cde Wap'. O.PuIyiocUIa', B.M1hllqlonlau'. B.PraImoI'

lMelcl1P!l)'IIcI DIpc., t.1UYInIly~ laldaa. LcmdcD. llK. 2AZ-VUB.DliplRadIodInpy,BnIIIeIs. B!LOItlM. 'INBrr. PIInt, GRIlIa!.4Al:1de11i1c1l MdIc:IICeleum,RIlIIalI-.:.pe. A-.IImLe..NImIBRLANDS. 'HIIIIaId UlIYcI*yoI'I'el:11alio1Y. HIIIiI*I, FINLAND.-. tl8lllpllll Jl!lyIIcI. KIroIbIID IIaIpiIII. S1ldIIaIm, SWBDBN, 'Dc:pc. 01~ Ii:NIIl:Ir:Ir Mdc:me. UIM*y 8llIpIlal CJla, GIll, BI!LCJIUM.~~ Dlipl,UWlnkyolPlall, PIInt, CllUlIlCB.

DYNARAD IsaJ!urclIaD C'.alIcer1ed AaIaa.~wI1IIlIlI CIIn'lIIt 1IIll

Illd~oI~~wIdIIDdieI!lIropoID t1DIoa.DYNARADCIIIIaII)' l1li26~ pIIdclpIItIIa1'IIpI'ClIOIIiI13CIllIIlIriIIl'ClIllllarop& 1'IIIl1llllliDlGroap Isa 1Ub-pJup 01DYNAllADClClIlllnId wIIIIlD lIII*lI ollllllmlllal c:IIIIIl illvCllved ill DyIIIIIlIc1lIdkldaenpy. 1'IIIlGroap _1dliadIId__~ IpICIac to imaIIAIIIId dIiI aIlIlnclllmlllO*-dII prollIa oIp1Ol11Jc1Da~y1."U"'1oa oIda'Ipy raIIMd IltormIdoa 011110 a..1JDIIe. 1'IIIl-uy01ClIIlIbiIIIIII idlnaIlIClII, IIIllaIparatlq pllIIIIIIric, t'uIIcdClIIallild IIplIIIaldlra,iulo ClIIIimIpb' pIIIIIllaa II~ 1'IIIl1llOdllldcl faroIlraiDIIIi1bII_1I'll~ U beiDa CclmpIl8cI 'I'aaqnipIIy(CT) orl1tenlaIIvdyDIpalT~ (DTS), PoOClII·JlIDc:lrClII 'I'aaIoIfIplIy (PET) orS_PIxxClII JlmIIIIoa CcIIIIpuIId1'clIIIDppIIy (SPIlC'I)IIld MtpeticReIaaaace IIIIIIIDI (MIU). Oae oldie IYIIIIIIlIimI oltlalmlliDlll'OUP Is110 full tboiDfcnIIaIiClIIl'ClIll tMlillC1llllCJ* II c:r.- aliDllo data..1IIOIt__II d)'llllllle radIadBapy1I'IaIIIIL 'l1III1pIlI'ClICII1bouId Joad tollllcnadClII oIllla11l11t1P1* viIlWIudClII oIl1n1Cl111'1, CllDIllanIlld pIIyIIaIotk:al1lIrldIo:a wbldl CXlIIId euI17 beraIIMd 10I!IlIaIaIar"-' l'IdIolblnpytI'eIIlI*I~. 1111 fIlI1bwIDI~.....1IlI eadyIillpWDce oItbeI!IIIIIDI <JnlIIp i1111l1 palWIIIIlI oIlIIII ailII.

138

THE TARGETED STEREOTACTIC RADIOSURGERY: AN OPTIMIZEDTREATMENT TECHNIQUE FOR PATIENTS WITH INTRACRANIA.VASCULAR MALFORMATIONS.

Prof. Dr. R. DATTA and Prof. Dr. S. DATTADepartment of Radiology, LSU School of Medicine,P.O. Box 33932, Shreveport, Louisiana-71130-3932, USA.

Stereotactic radiosurgery (SRS), a relatively new special treat­ment technique, has already occupied a prominent place in theexpanding armamentarium of therapeutic interventions of vas­cular abnormality associated with intracranial malformations.Usually, a massivedose of ionizing radiation, with single fractionis given by this procedure. Unlike multifractionated therapy. avery large single dose of radiation reduces the therapeutic ratio(i.e. radiobiologicallycontraindicated).Various different phys­ical methods and treatment devices have been developed to deliv­er highly localized dose distributions requiring targeting accuracyon the order of a millimeter. The physical accuracy of treatmentoutcome is comparable between methods. The physical aspects oftreatment techniquesof various methods and their impact on thetreatment and radiobiological considerations will be discussed.The technique appears to be applicable to patients with intracrani­al neoplasms in whom tumor volume is small and surgically inac­cessible, and in whom limited or no prior chemotheraphy hasbeen administered. What is stereotactic radiosurgery, how itworks, how it differs from stereotactic radiotherapy (SRT), whoare the potential candidates for treatment, and few other excitingquestions will be addressed to help physicians and physicists theappropriate use of this new emerging sophisticated technology.

140

TWO·DiMEfrnO~L VERSUS THREE·DIMENSIONAL TREATMENTPLANNING OF TANGENTIAL BREAST IRRADIATION.

E.M.F. DAMEN, I.A.D. BRUINVlS, B.J. MIJNHEERThe Netherlands Cancer Institute / Antoni van Leeuwenhoek Huis,Amsterdam, The Netherlands

Purpose: Full three-dimensional (3-D) treatment planning requires 3-Dpatientcontoursand densityinlormabon, derived e~her from CTscanningor from other 3-Dcontouring methods. These contouring techniquesaretime consuming, and are olten not available or cannot be used. Two­dimensional (2-D) treatmentplanning can be performed usingonlya fewpatientcontours,made with muchsimplertechniques,incombination withsimulator images for estimating the lung position. In order to investigatethe need lorlull 3-Dplanning, we compared the performance 01botha 2­D and a 3-D planning system in calculating absolute dose values andrelative dose distributions in tangential breast irradiation.Methods: Two breast-shaped phantomswere used in thisstUdy. Thefirstphantomconsists 01 a polyethylene mould, filled with waterand cork tomimic the lung.An ionization chamber can be inserted in the phantom etfixed positions, The second phantom is made 01 25 transverse slices 01polystyrene and cork,made with a computerized milling machine from CTinlormation. Inthis phantom, films can be Inserted inthree sagittal planes.Both phantoms have been irradiated with two tangential 8 MV photonbeams. Themeasured dose distribution has been comparedwith the dosedistribution predicted by the two planning systems.Results: In the central plane, the 3-D planning system predicts theabsolute dose with an accuracy 010.5 - 4%. The dose at the isocentre 01the beams agrees within 0.5%with the measured dose. The 2-D systempredictsthe dose with an accuracy010.9 - 3%.Thedose calculated at theisocentreis2.6%higherthan the measured dose, because missing lateralscatter is not taken intoaccount inthisplanning system. Inoil-axis planes.the calculated absolutedose agrees with the measured dose within 4%lorthe 2-D system and within 6% lor the 3-Dsystem. However, the relativedose distribution is predicted better by the 3·D planning system.Conclusions: This study shows that an algorithm lor the correction 01missing lateral scatter is an essential part 01 the treatment planning 01tangential fields, Furthermore, ~ is shownthat a multi-plane 2-D calculationmight be su1licienUy accurate in most cases.

837