A prone technique for treatment of the breast, supraclavicular and axillary nodes
| Autor: | Rebecca Owen, Robyn Guidi, Nicole Mason, Michael Poulsen, Deborah Macfarlane |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
medicine.medical_specialty
Supine position business.industry medicine.medical_treatment Surgery Radiation therapy Axilla Prone position medicine.anatomical_structure Oncology Radiation oncology medicine Axillary nodes Medical imaging Dosimetry Radiology Nuclear Medicine and imaging Nuclear medicine business |
| Zdroj: | Journal of Medical Imaging and Radiation Oncology. 56:362-367 |
| ISSN: | 1754-9477 |
| DOI: | 10.1111/j.1754-9485.2012.02389.x |
| Popis: | Radiation therapy to women with large pendulous breasts presents dosimetric challenges when the whole breast (WB) and supraclavicular and axillary (SCF + AX) nodes need to be encompassed. The aim of this case study was to demonstrate the feasibility of planning and treating a pendulous breasted patient in the prone position. Computerised tomography (CT) images were acquired of the patient in both the prone and supine positions. A Perspex plate was added to the CDR Systems Inc. (Calgary, Canada) prone breastboard to minimize SCF + AX contour variations. Dosimetry was performed on both CT scans and the resultant treatment plans were evaluated for conformity, homogeneity, dose to the lung and maximum doses to the spinal cord (SC) and irradiated volume. The daily set-up in the prone position was monitored for stability and reproducibility. The patient completed her treatment course in the prone position. Minimal daily interventions were required to ensure the position was reproduced. Grade 3 skin toxicity was recorded in the SCF + AX region where the Perspex plate was added to the prone positioning device. There was minimal difference in dosimetry between prone and supine plans in the SCF + AX region. The prone WB plan showed improved homogeneity (prone 0.15; supine 0.22) and conformity (prone 0.90; supine 0.77). A simple addition to the breastboard has enabled a pendulous breasted woman with SC + AX involvement to be treated in the prone position. Set-up of this technique is achievable on a daily basis with minimal impact on workflow. It is a feasible alternative to supine treatment for this patient group. © 2012 The Authors Journal of Medical Imaging and Radiation Oncology |
| Databáze: | OpenAIRE |
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