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Related Experiment Videos

Do metallic ports in tissue expanders affect postmastectomy radiation delivery?

Shari Damast1, Kathryn Beal, Ase Ballangrud

  • 1Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.

International Journal of Radiation Oncology, Biology, Physics
|August 15, 2006
PubMed
Summary

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The Magna-Site port in tissue expanders (TEs) can cause under-dosing during postmastectomy radiation therapy (PMRT). However, treating with a TE is acceptable, especially using 15 MV photons and compensating bolus.

Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Biomedical Engineering

Background:

  • Postmastectomy radiation therapy (PMRT) is a critical component of breast cancer treatment.
  • Patients may undergo radiation with a temporary tissue expander (TE) before receiving a permanent implant.
  • Concerns exist regarding potential under-dosing due to devices within the TE.

Purpose of the Study:

  • To investigate the dosimetric impact of the Magna-Site metallic port in TEs during PMRT.
  • To assess the potential for radiation dose reduction caused by the Magna-Site.
  • To provide recommendations for optimizing radiation delivery in patients with TEs.

Main Methods:

  • Ex vivo film dosimetry was performed using 6-MV and 15-MV photon beams on a water phantom with a Magna-Site disc.

Related Experiment Videos

  • In vivo exit dose measurements were taken from a patient's TE-reconstructed breast during chest wall treatment.
  • Thermoluminescent dosimeters (TLDs) were used to measure skin dose in patients receiving PMRT with TEs.

    • Main Results:

    • Film dosimetry showed decreased photon transmission through the Magna-Site, especially in the parallel orientation.
    • In vivo measurements confirmed the ex vivo findings of reduced transmission.
    • TLD data indicated acceptable variations in median skin dose, ranging from 86% to 101% of the prescription dose.

    Conclusions:

    • While treating PMRT patients with permanent implants is preferred, using a TE with a Magna-Site is not unreasonable due to the small affected tissue volume.
    • Recommendations include using 15 MV photons and compensating bolus when treating patients with TEs.
    • Further optimization of radiation techniques may be necessary to ensure adequate tumor coverage.