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KMID : 1164220120240020197
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Journal of Korean Society for Radiotherapeutic Technology
2012 Volume.24 No. 2 p.197 ~ p.203
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Case Report of Radiotherapy to a Breast Cancer Patient with a Pacemaker
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Chae Seung-Hoon
Park Jang-Pil
Lee Yang-Hoon
Yoo Suk-Hyun
Sung Won-Mo
Kim Kyu-Bo
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Abstract
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Purpose: In this study, we considerate our radiation therapy process for the breast cancer patient implanted a pacemaker applying the machine movement surgery, shielding, beam selection.
Materials and Methods: We perform radiation therapy to a 54 years old, breast cancer patient implanted a pacemaker. The patient underwent a surgery to move the position of a pacemaker to right side breast after consultation with cardiology department. Prescribed dose was 5,040 cGy and daily dose 180 cGy for 28 fractions. The 10 MV photon energy, field size 0/9.5×20 cm, half beam and opposing portal irradiation are used. To find out appropriate thickness of shielding board, we carried out an experiment using a solid water phantom (30×30×7 cm), a Farmer-type chamber (TN30013, PTW, Germany) and a shielding board (Pb 28×27×0.1 cm). We calculated expected absorbed dose to te pacemaker with absorb ratio and shielding ratio. In the PTP system (Eclipse, Varian, USA), we figured out how much radiation would be absorbed to the machine with and without shielding. First day of the radiation therapy, we measured head scatter to the pacemaker with MOSFET Dose Verification System (TN-RD-70-W, Medical Canada Ltd., Canada).
Results: In the phantom measurement, we found out appropriate thickness was 2 mm of shielding board. In the RTP, when using 2 mm shielding the pacemaker will be absorbed 11.5∼38.2 cGy and DVH is 77.3 cGy. In the first day of the therapy, 4.3 cGy was measured so 120.4 cGy was calculated during total therapy. The patient was free from any side effects, and the machine also normally functioned.
Conclusion: As the report of association which have public confidence became superannuated, there is lack of data about new machine. We believe that radiation therapy to thiese kind of patients could be done successfully with co-operation, patient-suitable planning, accurate QA, frequent in-vivo dosimetry and monitoring.
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KEYWORD
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pacemakers, breast cancer, shielding, radiotherapy
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