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Oncology Wavelengths |
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Dr. Garth Green: The new technique, used with our IMRT (intensity modulated radiation therapy) machine, is used most often for breast cancer patients, but we also use it for neck and head, lung, and pelvic tumors. For this discussion, we’ll assume we’re talking about a patient with breast cancer. The field-in-field technique enables us to be more precise within the area that is being targeted by the radiation. |
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GG: “Precise” meaning that the entire area receives a fairly uniform dosage. For example, if you radiate through a square object, you get a uniform dose throughout. But if you’re dealing with a triangle, there’s not as much tissue at the top of the triangle so the radiation creates a hot spot, meaning that the top receives more radiation than it would if it were a uniform shape. The bottom of the triangle is comparably colder because it’s getting less. Obviously, people are not uniform in shape and size, so that’s why we have this challenge. This technique is particularly important for larger women or women with larger breasts. The larger the breast is, the more redness, inflammation, swelling or scarring a patient tends to get at the inframammary fold [the bottom of the breast], which makes it difficult for those women to wear a bra. How long have we been using this technique? And do all breast cancer patients get this? GG: We have used this technique for a little more than a year. We have found that patients who have had this technique used as part of their treatment have less acute skin reactions and cosmetically better results. But only about 30 to 40 percent of the breast cancer patients receive it. Not everybody who undergoes traditional radiation therapy has major differences in the dose they receive throughout the breast, so those women don’t really need it. Also, this technique is more complicated for us to program; we have to do a lot of it by hand, as opposed to standard IMRT, in which we tell the computer what we want and the computer tells us what to do. The field-in-field technique keeps our physics department busy. But when it can provide a significant difference in outcome for a patient, it’s well worth it. And the difference in time involved for the patient is minimal. Now we’re working on more accurately defining which borderline cases will benefit from this technique. Continue » |
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