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SAVI
- Thread starter BraggPeak
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I guess a better way to ask the question is- do you include the pectoral is muscle in your chest wall contour, or do you just do the rib?
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Braggpeak: I am not familiar with the SAVI, but what would be the logic behind wanting to have dose into pectoral muscle, when you are treating low-risk breast cancer? The muscle cannot be CTV, right? So, why not spare it?
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Correct- no need to intentionally treat the muscle. However, is something that has to be considered when the savi/tumor bed are in close proximity to the pectoralis...similar to the issue with being close to skin
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Oh, sorry, now I understand. So you are asking for a constraint on the chest wall itself, not only the ribs, as an organ at risk.
Good question. I looked up the literature and found:
http://www.ncbi.nlm.nih.gov/pubmed/26816499
The way I see it, there was not constraint set to the chest wall or ribs. However "chest wall" was excluded from the PTV_Evaluation.
If you look at the images on the full paper you will see that the 100% isodose curves go deep into the chest wall, adjacent to the ribs (although not inside the ribs themselves), for example on image 6a. Thus it may be, that in practice these guys are only looking at dose on the ribs and not the chest wall.
Other authors looked into late toxicity on the chest wall. When doing so, they contoured the ribs only; not the chest wall.
http://www.ncbi.nlm.nih.gov/pubmed/22245195
They correlated rib/chest wall pain with maximal rib dose and volume of ribs receiving a high dose; not the chest wall again.
I dunno if you have access to the full papers. You can PM me, if you want to. Cheers, Alex
Good question. I looked up the literature and found:
http://www.ncbi.nlm.nih.gov/pubmed/26816499
The way I see it, there was not constraint set to the chest wall or ribs. However "chest wall" was excluded from the PTV_Evaluation.
If you look at the images on the full paper you will see that the 100% isodose curves go deep into the chest wall, adjacent to the ribs (although not inside the ribs themselves), for example on image 6a. Thus it may be, that in practice these guys are only looking at dose on the ribs and not the chest wall.
Other authors looked into late toxicity on the chest wall. When doing so, they contoured the ribs only; not the chest wall.
http://www.ncbi.nlm.nih.gov/pubmed/22245195
They correlated rib/chest wall pain with maximal rib dose and volume of ribs receiving a high dose; not the chest wall again.
I dunno if you have access to the full papers. You can PM me, if you want to. Cheers, Alex
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