Research Organization Document

Phase I
The Research Basics lecture identified the following steps in beginning the research
process:
1. Select a philosophical foundation
2. Determine group interest
3. Research your interests and develop a research problem
4. Find a supporting problem/develop a theory base (literature review)
5. Develop scientific question/query and select a research design
In the discussion forum, you should have narrowed down your interests into a single topic.
This document will help you apply these essential steps to your capstone project topic.
1. What philosophical foundation are you pursuing? Why?
The philosophical foundation we are pursuing is logical positivism. Comparing dose
conformity and OAR dose is observable and measurable.
2. What is your group interest? (This would be the high-level idea that you
listed/discussed in the discussion forum).

Our group is interested in comparing plan conformity and OAR dose in left sided
breast cancer patients. Currently MROCQ requirements have a goal of 1Gy mean
dose limit to the heart. Leakage through the MLCs for a heart block does not
currently provide enough blockage to meet this goal in some situations. We are
investigating whether using jaw tracking on FIF cases will allow us to meet this
requirement while still maintaining left breast PTV coverage.

3. Find a problem/develop a theory base. These concepts are combined because

both concepts support the idea that you need to determine what is out there on your
particular interest/topic.
a. What is the research problem? Your working problem statements below.
The problem in 3D planning is that transmission from static jaw techniques is
delivering unnecessary dose to OAR when left sided breast patients are treated
with FIF.

b. What knowledge exists on your interests and the problems you’ve come
up with?
 i. Conduct a literature review on your topics. If You’ve identified a
potential high-level problem to solve but how do you know that
someone else hasn’t already researched this problem? This is the
purpose of a literature review. You need to find peer-reviewed
scholarly articles that support the need for your proposed research.
The pertinent articles that you find will be used to confirm or refute
the results of your study so the research must be current (5 years old
at the most). The only circumstance in which older articles should be
used is in the case of task group reports, QUANTEC or similar
monumental articles. List the most pertinent articles that you intend
to use to support your research in AMA formatting in this document.
Refer to this list often. (Note: you will be providing summaries of
these articles in a later assignment so it’s a good idea to hold on to
notes about each article now).
New clinical research is showing the benefits of keeping the heart dose as low as possible.
While the average mean heart dose of left sided breast cancer patients has continued to
decline over the last decade from 5.4Gy to 3.6Gy, patients are still at risk of cardiac events
even more than a decade out from treatment. In a recent study, it was found that for every
1Gy of mean heart dose, a patient’s risk of a cardiac event went up 7.4%.2 MROCQ has set
a limit of .7 Gy for right sided breast patients and 1 Gy for left sided breast patients. We
are hypothesizing that an MLC heart block is not enough to meet this goal because of
transmission through the leaves. We would like to investigate whether jaw tracking FIF
would provide additional benefit in lowering the mean heart dose for left side breast
patients. In addition, we would like to see if this planning technique will aid in meeting
LAD dose constraints as well as lowering hotspots throughout the volume exceeding 107%
of the prescribed dose.
References:
1. Jung, S, Kim, JI, Park, JM, et al. Comparison of treatment plans between static jaw and
jaw tracking techniques in postmastectomy intensity-modulated radiation therapy. Phys
Eng Sci Med. 2022;45(1):181-187. doi:10.1007/s13246-022-01100-y
2. West, L, Latty, D, Beldham-Collins, R, et al. Patient-Specific heart constraint: A tool for
optimization and evaluation of mean heart dose in breast cancer patients. Practical
Radiat Oncol. 2021;11(2): e154–e162. https://doi.org/10.1016/j.prro.2020.10.005.
3. Yao S, Zhang, Y, Chen, T, et al. Dosimetric comparison between jaw tracking and no jaw
tracking in intensity-modulated radiation therapy. Technol in Cancer Res & Treatment.
2019;18:1-6. https://doi.org/10.1177/1533033819841061.
 4. What is the purpose of your study? This naturally falls in-line with the other
questions as you complete your literature review. What do you hope to find out
after you complete this research? What is the aim? These are all questions you
should ask yourselves.

The purpose of this study is to determine whether the use of jaw tracking will
improve heart sparing while maximizing target coverage in left sided breast
patients.

5. What are your supporting questions? Develop some key questions that your
reader will know the answer to after reading your research paper that support your
research problem. These questions should require elaboration (a simply stated
yes/no answer question is not permitted). For example:
a. Research Question: Where should our next coffee shop location be?
b. Supporting Questions: What customer base are we seeking?
1. Will using jaw tracking for FIF tangential breast patients reduce the mean heart dose
from the national average of 3.6Gy to the MROCQ goal of 1Gy while maintaining target
D95%≥ 100%?
2. Will using jaw tracking allow us to reduce left anterior descending artery (LAD) dose to
D0.1cc≤22Gy while maintaining target D95% ≥ 100%?
3. Will using jaw tracking allow us to reduce left anterior descending artery (LAD) dose to
a mean dose ≤3Gy while maintaining target D95% ≥ 100%?
4. Will using jaw tracking reduce hotspots below 107% while maintaining target D95% ≥
100%?

6. What type of research design are you interested in pursuing with this topic?
Some very basic information on each type (experimental/quantitative or
naturalistic/qualitative) was provided at the end of this week’s lecture. You will get
more into the research design in the coming weeks but you should determine which
design you are going to pursue now.

Quantitative: Experimental type

Submit this document to the appropriate assignment area when instructed.