This study evaluated the usability of conventional templates based on the new contour guidelines of the European Society of Radiation and Oncology and Advisory Committee in Radiation Oncology Practice (ESTRO-ACROP) for treatment plans of postmastectomy radiotherapy after immediate implant-based reconstruction. Intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) plans generated with two different treatment planning systems (TPSs, Eclipse and Monaco) were examined. Six computed tomography scans of patients aged 35-54 years were retrospectively analysed who had undergone mastectomy and breast reconstruction using silicone implants after being diagnosed with left breast cancer. Six radiation oncologists participated in this study, and each of them contoured the target volume of one left breast using conventional contour (CTV-CONV) and new contour (CTV-ESTRO) methods. This study showed that compared with CTV-CONV, using CTV-ESTRO with objectives and cost functions similar to those of TPSs worsened the target volume coverage and increased the total number of monitor units. Considering the organs at risk, CTV-ESTRO tended to increase the mean dose delivered to the contralateral lung. It is concluded that the approach used for the new ESTRO-ACROP contour method cannot be applied in a manner similar to that for the conventional breast contour method, implying that the new ESTRO-ACROP contour method may require more time for improving plans for a given treatment.

UNASSIGNED: The purpose of this study is to verify the accuracy of the commissioning of intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) based on the recommendation of the American Association of Physicists in Medicine Task Group 119 (TG-119).
UNASSIGNED: TG-119 proposes a set of clinical test cases to verify the accuracy of IMRT planning and delivery system. For these test cases, we generated two sets of treatment plans, the first plan using 7-9 IMRT fields and a second plan utilizing two-arc VMAT technique for both 6 MV and 15 MV photon beams. The template plans of TG-119 were optimized and calculated by Varian Eclipse Treatment Planning System (version 13.5). Dose prescription and planning objectives were set according to the TG-119 goals. The point dose (mean dose to the contoured chamber volume) at the specified positions/locations was measured using compact (CC-13) ion chamber. The composite planar dose was measured with IMatriXX Evaluation 2D array with OmniPro IMRT Software (version 1.7b). The per-field relative gamma was measured using electronic portal imaging device in a way similar to the routine pretreatment patient-specific quality assurance.
UNASSIGNED: Our planning results are compared with the TG-119 data. Point dose and fluence comparison data where within the acceptable confident limit.
UNASSIGNED: From the obtained data in this study, we conclude that the commissioning of IMRT and VMAT delivery were found within the limits of TG-119.

The Canadian Organization of Medical Physicists (COMP), in close partnership with the Canadian Partnership for Quality Radiotherapy (CPQR) has developed a series of Technical Quality Control (TQC) guidelines for radiation treatment equipment. These guidelines outline the performance objectives that equipment should meet in order to ensure an acceptable level of radiation treatment quality. The TQC guidelines have been rigorously reviewed and field tested in a variety of Canadian radiation treatment facilities. The development process enables rapid review and update to keep the guidelines current with changes in technology (the most updated version of this guideline can be found on the CPQR website). This particular TQC details recommended quality control testing for medical linear accelerators and multileaf collimators.