title: Clinical use of a wing field with transmission block for the treatment of the pelvis including the inguinal node.
abstract: Treatment planning of photon and electron beams to include the pelvis and the groin poses a technical difficulty of positioning beams, and a dosimetric problem of abutting fields at the groin. We have analyzed a simpler AP/PA method using a central transmission block. The posterior portal is smaller and opposes only the pelvic portion of the anterior portal under the transmission block, while the anterior extended portion (hence the wing) is unattenuated to treat the inguinal region. By calculating the attenuation thickness according to the patient's separation and the beam quality, the dose distribution is tailored to yield the proper dose to the pelvic mid-plane and the inguinal nodes while minimizing the dose to the femora. Measured dose distribution (6MV) using film dosimetry in a tissue-equivalent phantom indicates that a 30% hot spot is created by the posterior portal diverging into the wings of the anterior field. Therefore, the pelvic attenuator is tapered at its lateral edges, thereby significantly reduced the dose inhomogeneity (5%) at the groin. Clinical methods are outlined for the verification of the patient portal films against possible mismatch in beam divergence.
authors.affiliation: Department of Radiation Oncology, University of Pittsburgh, School of Medicine, PA 15213.
authors.forename: A M
authors.initials: AM
authors.lastname: Kalend
authors.forename: T L
authors.initials: TL
authors.lastname: Park
authors.forename: A
authors.initials: A
authors.lastname: Wu
authors.forename: S
authors.initials: S
authors.lastname: Kalnicki
authors.forename: A G
authors.initials: AG
authors.lastname: Meek
authors.forename: W D
authors.initials: WD
authors.lastname: Bloomer
authors.forename: E L
authors.initials: EL
authors.lastname: Solowsky
mesh_terms: D006119:Groin / Q000528:radiation effects; D006801:Humans; D007264:Inguinal Canal / Q000528:radiation effects*; D015182:Lymphatic Irradiation / Q000379:methods*; D010388:Pelvis / Q000528:radiation effects*; D011878:Radiotherapy / Q000295:instrumentation / Q000379:methods*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted