Corrigendum to "Harmonization of breast cancer radiotherapy treatment planning in the Netherlands" [Tech. Innov. Patient Support Radiat. Oncol. 19 (2021) 26-32].

[This corrects the article DOI: 10.1016/j.tipsro.2021.06.004.].

Harmonization of breast cancer radiotherapy treatment planning in the Netherlands.

PURPOSE: The aim was to reach consensus in The Netherlands on which parameters should be used to evaluate breast cancer radiotherapy (RT) plans. MATERIALS AND METHODS: A Benchmark Case with delineated planning target volumes (PTVs) and Organs At Risk (OARs) was sent to all Dutch radiotherapy centres in combination with a questionnaire, with the request to generate RT plans prescribing 15 times 2.67 Gy for four different treatment indications according to the institutional irradiation technique. The plans and accompanying questionnaire answers were analysed using descriptive statistics. These results, together with a harmonisation proposal, were sent to all centres. The proposal was discussed at a meeting of the Dutch Society of Radiation Oncology breast cancer platform. Distinct parameters were accepted if consensus on them was reached. RESULTS: 19 out of 20 Dutch departments participated in this study. PTV coverage varied considerably, with D98% between 63% and 99% for the breast and between 37% and 97% for the internal mammary nodes (IMN). Also substantial OAR dose differences were observed, with e.g. mean heart doses ranging between 1.85 Gy and 5.42 Gy in case the IMN were included in the PTV. For evaluation of the PTVs D98%, D2% and Dmean were chosen to report on, with target values of ≥ 95% (90% for the PTV_IMN), ≤ 107%, and 99-101%, respectively. For OARs, consensus was reached on the parameters to be evaluated, without target values: Dmean of the heart, Dmean and V5% of the lungs, and in case of periclavicular radiotherapy V30Gy of the thyroid gland. For patients younger than 40 years a contralateral mean breast dose of ≤ 1 Gy was agreed upon. CONCLUSION: A new Dutch consensus guideline for evaluation of breast cancer RT plans has been established.

Palliative chest irradiation in sitting position in patients with bulky advanced lung cancer.

Some patients with bulky advanced lung cancer are not able to lie down because of dyspnea. We therefore designed a technique for irradiation in a sitting position by using a dedicated chair. The reproducibility of the sitting position was high and all ten patients preferred this position over lying down. In selected patients who are unable to lie down, palliative irradiation in a sitting position may be an option.