Would you recommend radiation planning with air tissue expanders in patients who will receive PMRT?

I would suggest removal of air or replacement with fluids for dosimetric reasons.

We have also not yet treated with them in place. We've acquired for physics testing, as we expect to encounter them, but we are not anxious to incorporate into our practice.

I've recently seen a patient with them who will have them exchanged prior to treatment. One of the big logistical challenges ...

I have recently treated 1 patient with the air expander in place. It presented a significant dosimetric challenge requiring extensive consultation with the company's physicist and other institutions that the company said 'does it all the time'. No such institution exists. The patient insisted on pro...

N=1 but we saw a patient whose air expander spontaneously deflated between sim and treatment start.

Note also the company brochure states the remote control should be held by a physician during the duration of treatments (so the patient doesn't go home after sim or during treatment and decide she w...

Have had one patient with this but I had the plastic surgeon replace air with saline before planning.

We are facing 2 similar concerns:

1. Standard expanders filled with air by plastic surgeons. Few days before simulation we have air replaced with saline.

2. Air expanders which inflate with remote- challenge is air and metal canister which both impact dosimetry. Also the leads can obscure IM node ...