Optimising CT guided radiotherapy for breast cancer

The purpose of this thesis was to examine the potential of advanced radiotherapy technology for breast cancer.
Results show that computed tomography (CT) provides for the use of advanced radiotherapy techniques, such as three-dimensional conformal radiotherapy (3D-CRT) and computer optimised intensity modulated radiotherapy (IMRT). It also enables 3D definition of target volumes and organs at risk. However, availability of CT image information results in larger target volumes and larger irradiated volumes. Radiotherapy techniques must therefore be optimised to reduce the dose in organs at risk.
It was demonstrated that a simultaneously integrated boost (SIB), comprising whole breast and surgical cavity irradiation in a single radiotherapy plan, reduces excess dose delivered to breast tissue and organs at risk compared to conventional irradiation with separate plans, and requires less radiotherapy sessions. The use of costly IMRT-SIB instead of regular 3D-CRT-SIB offers benefits to particular patients only. Specific patient characteristics can be used to identify these patients.
Simultaneous regional lymph node irradiation requires larger radiation portals and larger volumes of organs at risk are irradiated. The combination of 3D-CRT photon and electron irradiation reduced the dose in the heart and the other breast compared to the use of photons only. 3D-CRT electron irradiation combined with IMRT photon irradiation better limited the prescribed dose to the target volumes, but increased normal tissue volumes receiving low dose irradiation.
The results of this research contribute substantially to improved quality of breast cancer radiotherapy.

	Titel en inhoudsopgave
	Hoofdstuk 1
	Hoofdstuk 2
	Hoofdstuk 3
	Hoofdstuk 4
	Hoofdstuk 5
	Hoofdstuk 6
	Hoofdstuk 7
	Summary and general discussion
	Algemene discussie
	Dankwoord
	Curriculum vitae
	Publicaties
	Volledige dissertatie

Meer informatie in de catalogus
Meer informatie in Picarta