Unit:
Κατεύθυνση Ιατρική Φυσική-ΑκτινοφυσικήLibrary of the School of Health Sciences
Author:
Papaioannou Eleni
Supervisors info:
Χρήστος Αντύπας, ΕΔΙΠ, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Χριστίνα Αρμπιλιά, ΕΔΙΠ, Ιατρική Σχολή, ΕΚΠΑ
Άννα Ζυγογιάννη, Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Αξιολόγηση της εθελούσιας βαθιάς εισπνοής (V-DIBH) στην 3Δ προσαρμοσμένη ακτινοθεραπεία του μαστού
Translated title:
Evaluation of Voluntary Deep inspiration Breath hold (V-DIBH) in 3D conformal Breast radiotherapy
Summary:
Studies of Deep Inspiration Breath hold patterns have been carried out in many clinics around the world. However most of them have focused on the effects of these patterns on patients who underwent irradiation for left breast cancer. In the present diploma thesis, following the implementation of these patterns in patients with right breast cancer, it is intended to study whether they can lead to the creation of an optimized treatment plan in which the dose that the Organs at Risk (OARs) receive is the smallest possible, while at the same time the PTV (Planning target volume) is covered sufficiently. As a result, it will reduce the occurrence of side effects in the individual in later years.
In this diploma, by using the Oncentra Treatment Planning System (TPS) and the 3D-CRT method, we studied how the treatment plans for two different CT scan differ for breast cancer patients. The first plan was designed based in the normal breathing state CT scan, while the second plan was based in the deep inspiration breath hold CT scan which was taken as the patient had inhaled deeply and held his breath. Our aim was to compare the treatment plans that were designed based to the two different CT scans both with regard to the doses received by the target tumor and the critical organs, as well as with the differentiation of their tumors.
After comparing treatment plans, we found that the V25 dose constraint for the heart, for left breasts showed a significant decrease. The minimum and the maximum dose at 1 cubic centi meter (ccm) of lung, for both the left and right breast cancer patients, showed a significant decrease. In other critical organs, such as the esophagus and the spinal cord, the results we obtained (for both left and right breast cancer patients) showed that the maximum and minimum dose in 1 ccm of each organ showed a significant increase with the use of DIBH patterns. However the total dose received for the esophagus, was decreased in DIBH patterns, while for the spinal cord the difference was not critical. In addition, the volume of the heart increased significantly in imaging. Still, it was found that doses in the heart and lungs increased in the case of Supra breasts, due to the addition of extra area for irradiation of the lymph nodes.
Main subject category:
Health Sciences
Keywords:
Breast cancer, Deep inspiration breath hold, Breast Radiotherapy, 3D-CRT, Dose
