Prog Med Phys.  2017 Dec;28(4):218-225. 10.14316/pmp.2017.28.4.218.

Evaluations and Comparisons of Body Surface Doses during Breast Cancer Treatment by Tomotherapy and LINAC Radiotherapy Devices

• Lee HJ
• Bae SH
• Cho KH
• Jeong JH
• Kwon SI
• Lee KD

• KMID: 2401384
• DOI: http://doi.org/10.14316/pmp.2017.28.4.218

Abstract

Effects on skin caused by the dose from linear accelerator (LINAC) opposing portal irradiation and TomoDirect 3-D modeling treatment according to the radiation devices and treatment methods were measured, and a comparative analysis was performed. Two groups of 10 patients each were created and measurements were carried out using an optically stimulated luminescence dosimeter. These patients were already receiving radiation treatment in the hospital. Using the SPSS statistical program, the minimum and maximum average standard deviations of the measured skin dose data were obtained. Two types of treatment method were selected as independent variables; the measured points and total average were the dependent variables. An independent sample T-test was used, and it was checked whether there was a significance probability between the two groups. The average of the measured results for the LINAC opposing portal radiation was 117.7 cGy and PDD 65.39% for the inner breast, 144.7 cGy and PDD 80.39% for the outer breast, 143.2 cGy and PDD 79.56% for the upper breast, 151.4 cGy and PDD 84.11% for the lower breast, 149.6 cGy and PDD 83.11% for the axilla, and 141.32 cGy and PDD 78.51% for the total average. In contrast, for TomoDirect 3-D conformal radiotherapy, the corresponding measurement values were 137.6 cGy and PDD 76.44%, 152.3 cGy and PDD 84.61%, 148.6 cGy and PDD 82.56%, 159.7 cGy and PDD 88.72%, and 148.6 cGy PDD 82.56%, respectively, and the total average was 149.36 cGy and PDD 82.98%. To determine if the difference between the total averages was statistically significant, the independent sample T-test of the SPSS statistical program was used, which indicated that the P-value was P=0.024, which was 0.05 lower than the significance level. Thus, it can be understood that the null hypothesis can be dismissed, and that there was a difference in the averages. In conclusion, even though the treatment dose was similar, there could be a difference in the dose entering the body surface from the radiation treatment plan; however, depending on the properties of the treatment devices, there is a difference in the dose affecting the body surface. Thus, the absorbed dose entering the body surface can be high. During breast cancer radiotherapy, radiation dermatitis occurs in almost all patients. Most patients have a difficult time while undergoing treatment, and therefore, when choosing a radiotherapy treatment method, minimizing radiation dermatitis is an important consideration.

Keyword

TomoDirect; LINAC; Breast cancer skin dose; OSL dosimetry

MeSH Terms

Axilla
Breast Neoplasms*
Breast*
Dermatitis
Humans
Luminescence
Methods
Particle Accelerators
Radiotherapy*
Radiotherapy, Conformal
Skin

Figure

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  Fig. 1 InLight OSL dosimetry system.

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  Fig. 2 Setup for calibration of OSL dosimeter — LINAC.

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  Fig. 3 Setup for calibration of OSL dosimeter — Tomotherapy.

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  Fig. 4 Locations of dose measurement where the OSL dosimeters were attached: ① Upper Breast, ② Inner Breast, ③ Lower Breast, ④ Outer Breast, and ⑤ Axilla.

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