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Topics:
Breast Cancer • Radiation Oncology
What plan parameters do you prioritize in 3D conformal breast treatment planning?
What normalization do you choose, what is your preferred target volume coverage, and how do you assess for homogeneity and heterogeneity?
Answer from: Radiation Oncologist at Community Practice
For whole breast 3D conformal RT, we contour surgical bed with 1 cm expansion for CTV and 3-5 mm for PTV.Coverage whole breast 95% of volume to 95% of dose we aim for but we accept 90 to 95.PTV (surgical bed) as above, 95% of volume to 100% of dose but accept 95 to 95 also.Volume of breast getting 1...
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Answer from: Radiation Oncologist at Academic Institution
My colleagues' approaches are reasonable. However, I would like to point out that there are few data to know what the optimal dose-fractionation, target goals, or normal-tissue constraints really are. (These issues are dealt with at greater length elsewhere - see Recht et al., PMID 30366007.)We bega...
Answer from: Radiation Oncologist at Academic Institution
We contour cavity, lungs, heart, cord.
With respect to evaluating plan, I typically place 105%, 100%, 95%, and 90% lines on. I look for 95% line to cover breast (I don't routinely contour breast for 3D plans). For RNI cases, I contour IMNs and set SCV +/- PAB fields, and look for 95% coverage of no...
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Radiation Oncologist at Lafayette Radiation Center
Almost identical to what I do.
Almost identical to what I do.
Answer from: Radiation Oncologist at Community Practice
Agree with @Sushil Beriwal and @Chirag S. Shah, but I do contour the breast tissue, that way there is an actual target. If you use the 95% isodose line to create the target, then it is automatically going to meet your coverage goal (by definition).
It doesn't take hours. I timed it and it tak...