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Proton-Accelerated Partial Breast Irradiation Treatment Planning

Course Details

MDCB Credits: 0.50

ARRT Credits: N/A

Available Until: 12/31/2019

Non-Member Price: $17.50

Member Price: $10.00

Member PLUS Price: $10.00

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Proton-Accelerated Partial Breast Irradiation Treatment Planning

Abstract
Proton Accelerated Partial Breast Irradiation (APBI) is a relatively new treatment technique that is being utilized at MD Anderson Proton Therapy Center. This treatment delivers conformal dose to the partial breast tumor bed, while sparing adjacent critical structures. In particular, the uninvolved normal breast tissue, contralateral breast, lungs, and heart are spared very well based on the unique characteristics of the proton beam.

This session will detail an overview of the treatment, target delineation and contouring, simulation and isocenter placement, beam orientation and optimization, DVH evaluation, and patient setup at treatment. After completion of the talk, listeners should gain a comprehensive knowledge of Proton ABPI.

Learning Objectives

  1. APBI Treatment Overview: Proton Beam Characteristics, Passive-Scatter Proton Therapy (Aperture and Compensator construction)
  2. Proton Margins for Uncertainty: Calculation of proximal, distal, and smearing margins
  3. Target Delineation and Contouring: GTV Tumor Bed, CTV Eval, PTV Eval, and Normal Structures
  4. Isocenter Placement: Considerations for imager clearance and image production
  5. Beam Orientation: 3-Beam orientation. Considerations for skin-sparing: large vs small hinge angles. Beam clearance
  6. Plan Optimization: Aperture fitting, compensator smoothing, and normalization
  7. DVH Evaluation: Requirements for coverage and normal tissue sparing
  8. Patient Setup at Treatment: Utilizing scar wire, bbs, and nipple marker
  9. Potential Future Directions of Proton APBI.

 

References and Acknowledgments

  • Strom, E A, et al. Proton Partial Breast Irradiation in the Supine Position: Treatment Description and Reproducibility of a Multibeam Technique., vol. 5, no. 4, July 2015, pp. e283-e290. PubMed, www.ncbi.nlm.nih/gov/pubmed/25804105
  • University of Texas MD Anderson Radiation Oncology Proton Dosimetry Planning Guidelines of APBI 2009-0818 Protocol. https://myteams.mdanderson.org/divisions/radonc/dosim/ptc/_layouts/15/WopiFrame.aspx?sourcedoc=/divisions/radonc/dosim/ptc/Breast%20Procedures%20and%20Guidelines/Breast_APBI_PlanningGuidelines2017.pptx&action=default
  • PTC Dosimetry Team (Mayank Amin, David Lege, Rola Georges, Katina Crabtree, Tyler Williamson, Rachel Hunter, Bobby Gongora, Catherine Evans