Saadeldin Ayat M, Elwan Azhar M
Radiation Oncology Department, El-Hussein University Hospital, Cairo, Egypt.
Biochemistry Department, National Research Centre, Giza, Egypt.
Rep Pract Oncol Radiother. 2020 Mar-Apr;25(2):168-173. doi: 10.1016/j.rpor.2020.01.007. Epub 2020 Jan 22.
Irradiating a tumor bed with boost dose after whole breast irradiation helps reducing the probability of local recurrence. However, the success of electron beam treatment with a small area aiming to cover a superficial lesion is a dual challenge as it requires an adequate dosimetry beside a double check for dose coverage with an estimation of various combined uncertainty of tumor location and losing lateral electron equilibrium within small field dimensions.
this work aims to measure the electron beam fluence within different field dimensions and the deviation from measurement performed in standard square electron applicator beam flatness and symmetry, then to calculate the average range of the correction factor required to overcome the loss of lateral electron equilibrium.
the electron beam used in this work generated from the linear accelerator model ELEKTA Precise and dosimetry system used were a pair of PTW Pin Point ion chambers for electron beam dosimetry at standard conditions and assessment of beam quality at a reference depth of measurement, with an automatic water phantom, then a Roos ion chamber was used for absolute dose measurement, and PTW 2Darray to investigate the beam fluence of four applicators 6, 10, 14 and 20 cm and 4 rectangular cutouts 6 × 14, 8 × 14, 6 × 17 and 8 × 17 cm, the second part was clinical application which was performed in a precise treatment planning system and examined boost dose after whole breast irradiation.
revealed that lower energy (6MeV and 8MeV) showed the loss of lateral electron equilibrium and deviation from measurements of a standard applicator more than the high energy (15 MeV) which indicated that the treatment of superficial dose with 6MeV required higher monitor unit to allow for the loss of lateral electron equilibrium and higher margin as well.
全乳照射后用加量剂量照射瘤床有助于降低局部复发的概率。然而,用小面积电子束治疗浅表病变的成功是一项双重挑战,因为除了要对剂量覆盖进行双重检查并估计肿瘤位置的各种综合不确定性以及在小射野尺寸内失去侧向电子平衡外,还需要进行适当的剂量测定。
本工作旨在测量不同射野尺寸下的电子束注量以及与标准方形电子限光筒束平坦度和对称性测量结果的偏差,然后计算克服侧向电子平衡损失所需的校正因子的平均范围。
本工作中使用的电子束由ELEKTA Precise型直线加速器产生,所使用的剂量测定系统是一对用于标准条件下电子束剂量测定和在参考测量深度评估束质的PTW针点电离室,配有自动水模体,然后使用Roos电离室进行绝对剂量测量,并用PTW二维阵列研究6、10、14和20 cm四种限光筒以及6×14、8×14、6×17和8×17 cm四种矩形切口的束注量,第二部分是临床应用,在精确治疗计划系统中进行并检查全乳照射后的加量剂量。
结果显示,低能量(6MeV和8MeV)比高能量(15MeV)更易出现侧向电子平衡损失以及与标准限光筒测量结果的偏差,这表明用6MeV治疗浅表剂量需要更高的监测单位以考虑侧向电子平衡损失,并且也需要更高的边界。