A dosimetry study of post-mastectomy radiation therapy with AeroForm tissue expander Journal Article


Authors: Lim, S. B.; Kuo, L. C.; Li, G.; Kuo, H. C.; McCormick, B.; Cahlon, O.; Powell, S.; Hong, L. X.
Article Title: A dosimetry study of post-mastectomy radiation therapy with AeroForm tissue expander
Abstract: Purpose: To evaluate the dosimetric effects of the AeroFormTM (AirXanpders®, Palo Alto, CA) tissue expander in-situ for breast cancer patients receiving post-mastectomy radiation therapy. Methods and Materials: A film phantom (P1) was constructed by placing the metallic canister of the AeroForm on a solid water phantom with EBT3 films at five depths ranging from 2.6 mm to 66.2 mm. A breast phantom (P2), a three-dimensional printed tissue-equivalent breast with fully expanded AeroForm in-situ, was placed on a thorax phantom. A total of 21 optical luminescent dosimeters (OLSDs) were placed on the anterior skin–gas interface and the posterior chest wall–metal interface of the AeroForm. Both phantoms were imaged with a 16-bit computed tomography scanner with orthopedic metal artifact reduction. P1 was irradiated with an open field utilizing 6 MV and 15 MV photon beams at 0°, 90°, and 270°. P2 was irradiated using a volumetric modulated arc therapy plan with a 6 MV photon beam and a tangential plan with a 15 MV photon beam. All doses were calculated using Eclipse (Varian, Palo Alto, CA) with AAA and AcurosXB (AXB) algorithms. Results: The average dose differences between film measurements and AXB in the region adjacent to the canister in P1 were within 3.1% for 15 MV and 0.9% for 6 MV. Local dose differences over 10% were also observed. In the chest wall region of P2, the median dose of OLSDs in percentage of prescription dose were 108.4% (range 95.4%–113.0%) for the 15MV tangential plan and 110.4% (range 99.1%–113.8%) for the 6MV volumetric modulated arc therapy plan. In the skin–gas interface, the median dose of the OLSDs were 102.3% (range 92.7%–107.7%) for the 15 MV plan and 108.2% (range 97.8–113.5%) for the 6 MV plan. Measured doses were, in general, higher than calculated doses with AXB calculations. The AAA dose algorithms produced results with slightly larger discrepancies between measurements compared with AXB. Conclusions: The AeroForm creates significant dose uncertainties in the chest wall–metal interface. The AcurosXB dose calculation algorithm is recommended for more accurate calculations. If possible, post-mastectomy radiation therapy should be delivered after the permanent implant is in place. © 2020 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals LLC on behalf of American Association of Physicists in Medicine.
Keywords: breast cancer; film dosimetry; aeroform tissue expander; olsd dosimetry; post-mastectomy radiation therapy
Journal Title: Journal of Applied Clinical Medical Physics
Volume: 21
Issue: 9
ISSN: 1526-9914
Publisher: American College of Medical Physics  
Date Published: 2020-09-01
Start Page: 33
End Page: 38
Language: English
DOI: 10.1002/acm2.12962
PUBMED: 32614518
PROVIDER: scopus
PMCID: PMC7497932
DOI/URL:
Notes: Article -- Export Date: 1 October 2020 -- Source: Scopus
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MSK Authors
  1. Simon Nicholas Powell
    331 Powell
  2. Linda Xueqi Hong
    88 Hong
  3. Oren Cahlon
    158 Cahlon
  4. Li Cheng Kuo
    63 Kuo
  5. Seng Boh Lim
    91 Lim
  6. Guang Li
    98 Li
  7. Beryl McCormick
    372 McCormick
  8. Hsiang-Chi Kuo
    22 Kuo
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