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Breast telecobalt beam therapy using multi-isocentric technique.

Balasubramanian Ananthi1, Rajasekaran Dhanabalan2, Iyer Priya1

  • 1Department of Radiation Oncology, Cancer Institute (WIA), Chennai, India.

Reports of Practical Oncology and Radiotherapy : Journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology
|January 8, 2020
PubMed
Summary

This study demonstrates that a multi-isocentric technique for image-based conformal radiotherapy planning in telecobalt units is feasible for breast cancer treatment, achieving acceptable toxicity levels.

Keywords:
Breast cancerComputed tomographyIsocentric techniqueTelecobaltThree dimensional

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Area of Science:

  • Oncology
  • Radiotherapy Physics
  • Medical Imaging

Background:

  • Breast cancer is a leading cause of cancer in women worldwide.
  • Increased early-stage diagnoses necessitate more radiotherapy.
  • Telecobalt units remain crucial in low-income countries due to cost-effectiveness and patient throughput.

Purpose of the Study:

  • To evaluate the efficacy of image-based conformal radiotherapy planning using a multi-isocentric technique for breast cancer patients treated with a telecobalt unit.
  • To assess the feasibility and toxicity of this planning technique in a resource-limited setting.

Main Methods:

  • Computed tomography (CT)-based planning was performed for 300 breast cancer patients.
  • A multi-isocentric technique was employed for three-dimensional radiotherapy planning.
  • Treatment verification and delivery were conducted using a digital simulator and a Theratron Phoenix telecobalt unit.

Main Results:

  • Dose distributions to organs at risk (heart, ipsilateral lung) and conformity indices met recommended standards.
  • While homogeneity index was not optimal, qualitative analysis allowed plan approval.
  • Acute skin reactions (grade 3) were observed in 3.6% of intact breast treatments and 3.5% of post-mastectomy treatments.

Conclusions:

  • A multi-isocentric technique is a viable alternative to single-isocenter planning in telecobalt units lacking advanced collimation systems.
  • Image-based planning enables dose distribution evaluation and beam modification for acceptable treatment outcomes.
  • This approach offers a feasible radiotherapy solution for breast cancer patients in settings utilizing telecobalt technology.