COMPARATIVE STUDY
JOURNAL ARTICLE
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Linac-based isocentric electron-photon treatment of radically operated breast carcinoma with enhanced dose uniformity in the field gap area.

BACKGROUND AND PURPOSE: Isocentric treatment technique is a standard method in photon radiotherapy with the primary advantage of requiring only a single patient set-up procedure for multiple fields. However, in electron treatments the size of the standard applicators does not generally allow to use an isocentric treatment technique. In this work we have modified and dosimetrically tested electron applicators for isocentric treatments in combination with photons. An isocentric treatment technique with photons and electrons for postmastectomy radiation therapy (PMRT) has been developed with special emphasis on improving the dose uniformity in the field gap area.

MATERIALS AND METHODS: Standard electron applicators of two Varian Clinac 2100CD linear accelerators were shortened by 10cm allowing isocentric treatments of 90cm
RESULTS: Depth dose characteristics of the shortened applicators remained unchanged from those of the standard applicators. Penumbrae were broadened by 0-3mm depending on electron energy and depth as the air gap was increased from 5cm (standard applicator at SSD=100cm) to 10cm (shortened applicator at SSD=95cm). The dose calculation performance of the modified applicators at 95cm
CONCLUSIONS: It is possible to apply an isocentric treatment technique in PMRT with electrons and photons. The homogeneity of the dose distribution can be improved by adding more photon field segments. With the isocentric technique it is possible to achieve even some time sparing in treatment delivery compared with the traditional SSD=100cm technique.

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