Clinical implementation of combined modulated electron and photon beams with conventional MLC for accelerated partial breast irradiation

Publication date: Available online 20 June 2017
Source:Radiotherapy and Oncology
Author(s): Carlos Míguez, Elisa Jiménez-Ortega, Bianey A. Palma, Hector Miras, Ana Ureba, Rafael Arráns, Francisco Carrasco-Peña, Ana Illescas-Vacas, Antonio Leal
PurposeTo report the clinical implementation of a novel external beam radiotherapy technique for accelerated partial breast irradiation treatments based on combined electron and photon modulated beams radiotherapy (MERT+IMRT) with conventional MLC.Materials and methodsA group of patients was selected to test the viability of the technique. The prescribed dose was 38.5Gy, following a hypofractionated schema, and the structures were defined following the NSABP-B39/RTOG-0413 protocol. The plans were calculated with an in-house Monte Carlo based planning system to consider explicitly the particle interactions with the MLC. An ad-hoc breast phantom was designed for a specific QA protocol. A reduced SSD was used for electron beams. Toxicity and cosmetic effects were assessed at every follow-up visit.ResultsAll the plans achieved the dosimetric objectives and fulfilled the specific quality assurance protocol. Treatment delivery did not entail additional drawbacks for the clinical routine. Moderate or severe grade of toxicity was not reported, and the cosmetic results were comparable to those obtained with other APBI techniques.ConclusionsResults showed that MERT+IMRT with the MLC is a feasible and secure technique, and easy to be extended to other centers with the implementation of the adequate software for planning.



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