Does your dosimetrist use skin flash for VMAT whole breast or RNI plans?

Please note that my question excludes VMAT PBI. There are papers describing VMAT breast techniques utilizing virtual bolus for skin flash and other papers that do not (notably MSKCC's published RNI technique). Does your planner use virtual bolus for skin flash? If not, why not?

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Does your planner use skin flash for VMAT whole breast +/- RNI? This excludes APBI.

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Radiation Oncology · Varian Medical Systems/Allegheny health network

Answered on

We do routinely to account for set-up uncertainty and intrafraction motion. With VMAT, the auto flash features are built in but with VMAT, use virtual bolus technique.

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