Electron radiotherapy (IOERT) for applications outside of the breast: Dosimetry and influence of tissue inhomogeneities |
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| Institution: | 1. Department of Medical Physics, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy;2. Medical Physics, Bhaktapur Cancer Hospital, Katmandu, Nepal;3. Medical Physics, ULSS 1 Dolomiti- S. Martino Hospital, Medical Physics Department, Belluno, Italy;4. Medicinal Supplies, Medical Physics Division, Hanoi Oncology Hospital, Hanoi, Vietnam;5. Oncology Department, Komfo Anokye Teaching Hospital, Kumasi, Ghana;6. Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy;7. Surgical Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy;8. Guerbet SA, Villepinte, France;1. Institute for Onco-Physics, Albert Einstein College of Medicine, Bronx, NY;2. Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY;3. Department of Urology, Montefiore Medical Center, Bronx, NY;4. Department of Surgery, Montefiore Medical Center, Bronx, NY;5. Department of Neurology, Albert Einstein College of Medicine, Bronx, NY;1. Physics Department, Hakim Sabzevari University, Shohada-e Hastei Blvd, P.O. 9617976487, Sabzevar, Iran;2. Department of Medical Physics and Radiological Sciences, Sabzevar University of Medical Sciences, Shohada-e Hastei Blvd, Sabzevar University of Medical Sciences Campus, P.O. 9617913112, Sabzevar, Iran;3. Vasei Radiotherapy & Oncology Center, Vasei Hospital, P.O. 9617913113, Sabzevar, Iran;4. Department of Medical Physics, Iran University of Medical Sciences. Hemmat Exp. Way, Faculty of Medicine, P.O. 14496141525, Tehran, Iran;5. Department of Breast Surgery, Iran University of Medical Sciences. Hemmat Exp. Way, Faculty of Medicine, P.O. 14496141525, Tehran, Iran;6. Cancer Research Center, Shahid Beheshti University of Medical Sciences, Shohadaye Tajrrish Hospital, Tajrish Sq., P.O. 19996 14414, Tehran, Iran;1. ENEA, National Institute of Ionizing Radiation Metrology, Via Anguillarese 301, 00123 Rome, Italy;2. ENEA, Radiation Protection Institute, Bologna Via Martiri di Monte Sole 4, 40129 Bologna, Italy;3. Istituto Regina Elena, Via Elio Chianesi 53, 00144 Rome, Italy;1. Nuclear Metrology, école polytechnique, université Libre de Bruxelles, Bruxelles, Belgium;2. Radiothérapy Department, institut Jules-Bordet, Bruxelles, Belgium;1. Department of Medical Physics, Tehran University of Medical Science, Poursina St, 1417614411 Tehran, Iran;2. Department of Medical Physics, Iran University of Medical Science, Hemmat Exp. Way, 14496141525 Tehran, Iran;3. Department of Radiation Medicine, Shahid Beheshti University, Daneshjoo St, Velenjak, 1983963113 Tehran, Iran;1. Department of Electronic Engineering, University of Valencia, E-46100, Spain;2. IRIMED, Unidad Mixta de Investigacion en Radiofisica e Instrumentacion Nuclear en Medicina IIS Hospital La Fe – Universitat de Valencia, Spain;3. S.I.T. – Sordina IORT Technologies SpA, Vicenza, Italy;4. Department of Physical Therapy, University of Valencia, E-46010, Spain;5. Department of Radiation Oncology, La Fe Polytechnic and University Hospital, Valencia E-46026, Spain |
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| Abstract: | PurposeThe purpose of study is to investigate the dosimetry of electron intraoperative radiotherapy (IOERT) of the Intraop Mobetron 2000 mobile LINAC in treatments outside of the breast. After commissioning and external validation of dosimetry, we report in vivo results of measurements for treatments outside the breast in a large patient cohort, and investigate if the presence of inhomogeneities can affect in vivo measurements.Methods and materialsApplicator factors and profile curves were measured with a stereotactic diode. The applicators factors of the 6 cm flat and beveled applicators were also confirmed with radiochromic films, parallel-plate ion chamber and by an external audit performed with ThermoLuminescent Dosimeters (TLDs). The influence of bone on dose was investigated by using radiochromic films attached to an insert equivalent to cortical bone, immersed in the water phantom. In vivo dosimetry was performed on 126 patients treated with IOERT using metal oxide-silicon semiconductor field effect transistors (MOSFETs) placed on the tumor bed.ResultsRelatively small differences were found among different detectors for measurements of applicator factors. In the external audit, the agreement with the TLD was mostly within ±0.2%. The largest increase of dose due to the presence of cortical bone insert was +6.0% with energy 12 MeV and 3 cm applicator. On average, in vivo dose was significantly (+3.1%) larger than prescribed dose.ConclusionIOERT in applications outside the breast results in low discrepancies between in vivo and prescribed doses, which can be also explained with the presence of tissue inhomogeneity. |
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| Keywords: | Intra-operative Radiation therapy Dosimetry Radiochromic film Electron therapy |
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