open access

Vol 25, No 1 (2020)
Original research articles
Published online: 2020-01-01
Submitted: 2018-03-22
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Breast telecobalt beam therapy using multi-isocentric technique

Balasubramanian Ananthi, Rajasekaran Dhanabalan, Iyer Priya, Ganesarajah Selvaluxmy, Nagarajan Vivekanandan
DOI: 10.1016/j.rpor.2019.12.009
·
Rep Pract Oncol Radiother 2020;25(1):79-84.

open access

Vol 25, No 1 (2020)
Original research articles
Published online: 2020-01-01
Submitted: 2018-03-22

Abstract

Aim

To treat breast cancer patients in telecobalt unit with image based conformal radiotherapy planning using the multi-isocentric technique.

Background

Breast cancer is the leading cancer among all the female cancers. With improved screening techniques, many patients are being diagnosed at an early stage and the need for radiotherapy in such patients has increased. The telecobalt machine is still a preferred machine in many of the low income countries as it is cost-effective and can offer uninterrupted treatment to large number of patients.

Materials and Methods

Three hundred patients requiring radiotherapy had a computed tomography based planning. Patients were immobilized using a breast board with a thermoplastic mould. Three dimensional planning was done with the multi-isocentric technique. These patients were then simulated using a Nucletron Simulix digital simulator for field verification and were treated in a Theratron Phoenix telecobalt treatment unit.

Results

The doses to the heart, ipsilateral lung and the conformity index were within the recommended values. The homogeneity index was not comparable; however, a section by section qualitative analysis was done and a final plan approved. As per the RTOG toxicity grading system, acute skin reaction grade 3 was observed in 3.6% of treatments to intact breast including nodal regions and in 3.5% of post mastectomy radiation patients.

Conclusion

Single isocenter technique was not feasible as the telecobalt unit did not have multileaf collimators and asymmetric jaws. With improved image based planning, a multi-isocentric technique was planned. By evaluating the dose distribution, beam modifications can be made and treatments can be given with acceptable toxicity.

Abstract

Aim

To treat breast cancer patients in telecobalt unit with image based conformal radiotherapy planning using the multi-isocentric technique.

Background

Breast cancer is the leading cancer among all the female cancers. With improved screening techniques, many patients are being diagnosed at an early stage and the need for radiotherapy in such patients has increased. The telecobalt machine is still a preferred machine in many of the low income countries as it is cost-effective and can offer uninterrupted treatment to large number of patients.

Materials and Methods

Three hundred patients requiring radiotherapy had a computed tomography based planning. Patients were immobilized using a breast board with a thermoplastic mould. Three dimensional planning was done with the multi-isocentric technique. These patients were then simulated using a Nucletron Simulix digital simulator for field verification and were treated in a Theratron Phoenix telecobalt treatment unit.

Results

The doses to the heart, ipsilateral lung and the conformity index were within the recommended values. The homogeneity index was not comparable; however, a section by section qualitative analysis was done and a final plan approved. As per the RTOG toxicity grading system, acute skin reaction grade 3 was observed in 3.6% of treatments to intact breast including nodal regions and in 3.5% of post mastectomy radiation patients.

Conclusion

Single isocenter technique was not feasible as the telecobalt unit did not have multileaf collimators and asymmetric jaws. With improved image based planning, a multi-isocentric technique was planned. By evaluating the dose distribution, beam modifications can be made and treatments can be given with acceptable toxicity.

Get Citation

Keywords

Telecobalt; Breast cancer; Computed tomography; Isocentric technique; Three dimensional

About this article
Title

Breast telecobalt beam therapy using multi-isocentric technique

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 25, No 1 (2020)

Pages

79-84

Published online

2020-01-01

DOI

10.1016/j.rpor.2019.12.009

Bibliographic record

Rep Pract Oncol Radiother 2020;25(1):79-84.

Keywords

Telecobalt
Breast cancer
Computed tomography
Isocentric technique
Three dimensional

Authors

Balasubramanian Ananthi
Rajasekaran Dhanabalan
Iyer Priya
Ganesarajah Selvaluxmy
Nagarajan Vivekanandan

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