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Contralateral breast dose with electronic compensators and conventional tangential fields - A clinical dosimetric

Prabhakar Ramachandran1, Amanda Smith2, Jim Hagekyriakou2

  • 1Princess Alexandra Hospital, Queensland, Australia.

Zeitschrift Fur Medizinische Physik
|June 15, 2021
PubMed
Summary

Electronic tissue compensation (eComp) reduces contralateral breast dose in radiotherapy. This technique shows a significantly lower dose at 1cm depth compared to standard tangential fields, potentially lowering secondary cancer risk.

Keywords:
BreastDosimetryElectronic compensatorsRadiation oncologyTangential fields

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Oncology

Background:

  • Radiotherapy for breast cancer can lead to secondary cancers due to dose to the contralateral breast (CLB).
  • Electronic tissue compensation (eComp) is an alternative to conventional 3D-conformal radiotherapy, eliminating the need for wedges.
  • Limited data exists on CLB dose with eComp tangential fields.

Purpose of the Study:

  • To measure and compare the dose to the contralateral breast (CLB) between eComp and standard tangential fields in breast cancer radiotherapy.
  • To assess the potential reduction in secondary cancer risk with eComp.

Main Methods:

  • A randomized trial involving 40 breast cancer patients (20 eComp, 20 standard).
  • Thermoluminescence dosimeters (TLDs) were used to measure surface and 1cm depth doses to the CLB.
  • Measurements were taken at 3cm from the medial tangential border for both techniques.

Main Results:

  • Mean surface doses were comparable (10.04% for eComp vs. 10.14% for standard).
  • Dose at 1cm depth was significantly lower with eComp (5.12%) compared to standard fields (6.29%) (p<0.05).
  • Excess relative risk (ERR) for secondary cancers was lower for eComp (0.08) than standard (0.11).

Conclusions:

  • The eComp technique significantly reduces the dose to the contralateral breast at 1cm depth compared to standard tangential fields.
  • eComp does not increase surface dose to the CLB.
  • eComp offers a potentially safer radiotherapy option for breast cancer patients by reducing secondary cancer risk.