ABSTRACT
Objective: This study presents the dosimetric data taken with radiochromic EBT3 film with brass mesh bolus using solid water and semi-breast phantoms, and its clinical implementation to analyze the surface dose estimates to the chest wall in postmastectomy radiotherapy (PMRT) patients. Materials and Methods: Water-equivalent thickness of brass bolus was estimated with solid water phantom under 6 megavoltage photon beam. Following measurements with film were taken with no bolus, 1, 2, and 3 layers of brass bolus: (a) surface doses on solid water phantom with normal incidence and on curved surface of a locally fabricated cylindrical semi-breast phantom for tangential field irradiation, (b) depth doses (in solid phantom), and (c) surface dose measurements around the scar area in six patients undergoing PMRT with prescribed dose of 50 Gy in 25 fractions. Results: Water-equivalent thickness (per layer) of brass bolus 2.09 ± 0.13 mm was calculated. Surface dose measured by film under the bolus with solid water phantom increased from 25.2% ±0.9% without bolus to 62.5% ± 3.1%, 80.1% ± 1.5%, and 104.4% ± 1.7% with 1, 2, and 3 layers of bolus, respectively. Corresponding observations with semi-breast phantom were 32.6% ± 5.3% without bolus to 96.7% ± 9.1%, 107.3% ± 9.0%, and 110.2% ± 8.7%, respectively. A film measurement shows that the dose at depths of 3, 5, and 10 cm is nearly same with or without brass bolus and the percentage difference is <1.5% at these depths. Mean surface doses from 6 patients treated with brass bolus ranged from 79.5% to 84.9%. The bolus application was discontinued between 18th and 23rd fractions on the development of Grade 2 skin toxicity for different patients. The total skin dose to chest wall for a patient was 3699 cGy from overall treatment with and without bolus. Conclusions: Brass mesh bolus does not significantly change dose at depths, and the surface dose is increased. This may be used as a substitute for tissue-equivalent bolus to improve surface conformity in PMRT
ABSTRACT
Background: Breast cancer is one of the most frequent occurring cancers in women and burgeoning worldwide. It is the second most common malignancy in India after carcinoma of the uterine cervix. In clinical trials, quality of life (QOL) outcome measurements is an important as endpoints with improving subjects physical, emotional, and social well-being. Methods: In this study, we were evaluated the comparison of the QOL in breast cancer patients on anthracycline-based regimen (six cycles of 5-fluorouracil, adriamycin, and cyclophosphamide [FAC] for a period of 18 weeks) and taxane-containing regimen (four cycles of adriamycin and cyclophosphamide [AC] followed by four cycles of paclitaxel [PTX] for a period of 24 weeks) using European Organization for Research and Treatment of Cancer Quality of Questionnaire-Core 30. Results: During first 3 months of therapy, both treatment groups exhibited a reduction in health-related QOL (HRQOL) with no clinically significant difference between them. The effect on HRQOL was less evident 3 weeks after completing chemotherapy with HRQOL of both groups returning to near baseline scores. Conclusions: Both treatment regimens (FAC and AC → PTX [AC followed by PTX]) were equally tolerated in patients.
ABSTRACT
We report a rare case of second primary lung cancer presenting metachronoulsy in a patient with laryngeal cancer. Though regional recurrence and second primary neoplasm of the upper aerodigestive tract are common following laryngeal cancers, second primary cancers of the lung are uncommon. Adding to the rarity of the case was the presence of concurrent active pulmonary tuberculosis with second primary neoplasm of the lung.